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Kidney Veno-Muscular Characteristics and Kidney Disease Progression: A Native Kidney-Biopsy Study

RATIONALE & OBJECTIVE: Assessment of kidney biopsies provides crucial information for diagnosis and disease activity, as well as prognostic value. Kidney-biopsy specimens occasionally contain veno-muscular complex (VMC), which consists of muscle tissues around the kidney venous system in the cor...

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Autores principales: Tsuji, Kenji, Nakanoh, Hiroyuki, Takahashi, Kensaku, Morita, Takafumi, Sang, Yizhen, Fukushima, Kazuhiko, Matsuoka-Uchiyama, Natsumi, Onishi, Yasuhiro, Uchida, Haruhito A., Kitamura, Shinji, Wada, Jun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10692955/
https://www.ncbi.nlm.nih.gov/pubmed/38046910
http://dx.doi.org/10.1016/j.xkme.2023.100733
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author Tsuji, Kenji
Nakanoh, Hiroyuki
Takahashi, Kensaku
Morita, Takafumi
Sang, Yizhen
Fukushima, Kazuhiko
Matsuoka-Uchiyama, Natsumi
Onishi, Yasuhiro
Uchida, Haruhito A.
Kitamura, Shinji
Wada, Jun
author_facet Tsuji, Kenji
Nakanoh, Hiroyuki
Takahashi, Kensaku
Morita, Takafumi
Sang, Yizhen
Fukushima, Kazuhiko
Matsuoka-Uchiyama, Natsumi
Onishi, Yasuhiro
Uchida, Haruhito A.
Kitamura, Shinji
Wada, Jun
author_sort Tsuji, Kenji
collection PubMed
description RATIONALE & OBJECTIVE: Assessment of kidney biopsies provides crucial information for diagnosis and disease activity, as well as prognostic value. Kidney-biopsy specimens occasionally contain veno-muscular complex (VMC), which consists of muscle tissues around the kidney venous system in the corticomedullary region. However, the role of VMC and the clinical significance of VMC variants are poorly understood. In the present study, we investigated kidney prognostic values of VMC variants. STUDY DESIGN: Retrospective cohort study. SETTING & PARTICIPANTS: Among 808 patients who underwent a kidney biopsy from 2011 to 2019, 246 patients whose kidney biopsy specimens contained VMC were enrolled. PREDICTORS: VMC variants; inflammatory-VMC (an infiltration of ≥80 inflammatory cells/mm(2)-VMC area) and VMC hypertrophy (hyper-VMC, a VMC average width ≥850 μm), and the interstitial fibrosis/tubular atrophy (IFTA) score. OUTCOMES: A decline in estimated glomerular filtration rate (eGFR) ≥40% from the baseline or commencement of kidney replacement therapy. ANALYTICAL APPROACH: Cox proportional hazards model. RESULTS: Among 246 patients with data on VMC, mean baseline eGFR was 56.0±25.6 ml/min per 1.73 m(2); 80 had high inflammatory-VMC, and 62 had VMC hypertrophy. There were 51 kidney events over median follow-up of 2.5 years. We analyzed 2 VMC variants. Multivariable logistic regression analysis revealed that eGFR negatively correlated with the presence of both inflammatory-VMC and hyper-VMC. A Cox proportional hazards analysis revealed that inflammatory-VMC (but not hyper-VMC) was independently associated with the primary outcome after adjustments for known risk factors of progression, including proteinuria, eGFR, and the interstitial fibrosis/tubular atrophy (IFTA) score (hazard ratio, 1.97; 95% confidence interval, 1.00-3.91). LIMITATIONS: Single-center study and small sample size. CONCLUSIONS: Assessment of inflammatory-VMC provides additional kidney prognostic information to known indicators of kidney disease progression in patients who undergo kidney biopsy. PLAIN-LANGUAGE SUMMARY: Assessment of kidney biopsies provides crucial information for diagnosis, disease activity, and prognostic value. Kidney-biopsy specimens occasionally contain veno-muscular complex (VMC), which consists of muscle tissues around the kidney venous system. Currently, the role of VMC in kidney health and diseases and the clinical significance of VMC variants are poorly understood. In the present study, we have shown that an infiltration of ≥80 inflammatory cells/mm(2)-VMC area (inflammatory-VMC) is independently associated with kidney disease progression after adjustments for known risk factors of progression. Therefore, assessment of inflammatory-VMC provides additional kidney prognostic information to known indicators of kidney disease progression in patients who undergo kidney biopsy.
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spelling pubmed-106929552023-12-03 Kidney Veno-Muscular Characteristics and Kidney Disease Progression: A Native Kidney-Biopsy Study Tsuji, Kenji Nakanoh, Hiroyuki Takahashi, Kensaku Morita, Takafumi Sang, Yizhen Fukushima, Kazuhiko Matsuoka-Uchiyama, Natsumi Onishi, Yasuhiro Uchida, Haruhito A. Kitamura, Shinji Wada, Jun Kidney Med Original Research RATIONALE & OBJECTIVE: Assessment of kidney biopsies provides crucial information for diagnosis and disease activity, as well as prognostic value. Kidney-biopsy specimens occasionally contain veno-muscular complex (VMC), which consists of muscle tissues around the kidney venous system in the corticomedullary region. However, the role of VMC and the clinical significance of VMC variants are poorly understood. In the present study, we investigated kidney prognostic values of VMC variants. STUDY DESIGN: Retrospective cohort study. SETTING & PARTICIPANTS: Among 808 patients who underwent a kidney biopsy from 2011 to 2019, 246 patients whose kidney biopsy specimens contained VMC were enrolled. PREDICTORS: VMC variants; inflammatory-VMC (an infiltration of ≥80 inflammatory cells/mm(2)-VMC area) and VMC hypertrophy (hyper-VMC, a VMC average width ≥850 μm), and the interstitial fibrosis/tubular atrophy (IFTA) score. OUTCOMES: A decline in estimated glomerular filtration rate (eGFR) ≥40% from the baseline or commencement of kidney replacement therapy. ANALYTICAL APPROACH: Cox proportional hazards model. RESULTS: Among 246 patients with data on VMC, mean baseline eGFR was 56.0±25.6 ml/min per 1.73 m(2); 80 had high inflammatory-VMC, and 62 had VMC hypertrophy. There were 51 kidney events over median follow-up of 2.5 years. We analyzed 2 VMC variants. Multivariable logistic regression analysis revealed that eGFR negatively correlated with the presence of both inflammatory-VMC and hyper-VMC. A Cox proportional hazards analysis revealed that inflammatory-VMC (but not hyper-VMC) was independently associated with the primary outcome after adjustments for known risk factors of progression, including proteinuria, eGFR, and the interstitial fibrosis/tubular atrophy (IFTA) score (hazard ratio, 1.97; 95% confidence interval, 1.00-3.91). LIMITATIONS: Single-center study and small sample size. CONCLUSIONS: Assessment of inflammatory-VMC provides additional kidney prognostic information to known indicators of kidney disease progression in patients who undergo kidney biopsy. PLAIN-LANGUAGE SUMMARY: Assessment of kidney biopsies provides crucial information for diagnosis, disease activity, and prognostic value. Kidney-biopsy specimens occasionally contain veno-muscular complex (VMC), which consists of muscle tissues around the kidney venous system. Currently, the role of VMC in kidney health and diseases and the clinical significance of VMC variants are poorly understood. In the present study, we have shown that an infiltration of ≥80 inflammatory cells/mm(2)-VMC area (inflammatory-VMC) is independently associated with kidney disease progression after adjustments for known risk factors of progression. Therefore, assessment of inflammatory-VMC provides additional kidney prognostic information to known indicators of kidney disease progression in patients who undergo kidney biopsy. Elsevier 2023-10-05 /pmc/articles/PMC10692955/ /pubmed/38046910 http://dx.doi.org/10.1016/j.xkme.2023.100733 Text en © 2023 The Authors https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Original Research
Tsuji, Kenji
Nakanoh, Hiroyuki
Takahashi, Kensaku
Morita, Takafumi
Sang, Yizhen
Fukushima, Kazuhiko
Matsuoka-Uchiyama, Natsumi
Onishi, Yasuhiro
Uchida, Haruhito A.
Kitamura, Shinji
Wada, Jun
Kidney Veno-Muscular Characteristics and Kidney Disease Progression: A Native Kidney-Biopsy Study
title Kidney Veno-Muscular Characteristics and Kidney Disease Progression: A Native Kidney-Biopsy Study
title_full Kidney Veno-Muscular Characteristics and Kidney Disease Progression: A Native Kidney-Biopsy Study
title_fullStr Kidney Veno-Muscular Characteristics and Kidney Disease Progression: A Native Kidney-Biopsy Study
title_full_unstemmed Kidney Veno-Muscular Characteristics and Kidney Disease Progression: A Native Kidney-Biopsy Study
title_short Kidney Veno-Muscular Characteristics and Kidney Disease Progression: A Native Kidney-Biopsy Study
title_sort kidney veno-muscular characteristics and kidney disease progression: a native kidney-biopsy study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10692955/
https://www.ncbi.nlm.nih.gov/pubmed/38046910
http://dx.doi.org/10.1016/j.xkme.2023.100733
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