20.500.12556/DKUM-91276 The role of vascular lesions in diabetes across a spectrum of clinical kidney disease Introduction: The clinical-histologic correlation in diabetic nephropathy is not completely known. Methods: We analyzed nephrectomy specimens from 90 patients with diabetes and diverse degrees of proteinuria and glomerular filtration rate (GFR). Results: Thirty-six (40%) subjects had normoalbuminuria, 33 (37%) microalbuminuria, and 21 (23%) non-nephrotic proteinuria. Mean estimated GFR (eGFR) was 65±23 (40% <60 ml/min per 1.73 m2). About 170 glomeruli per patient were analyzed, and all samples included vascular tissue. Six subjects (7%) were classified in diabetic nephropathy class I, 61 (68%) in class II-a, 13 (14%) in class II-b, 9 (10%) class III, and 1 (1%) in class IV. Eighty percent to 90% of those with normoalbuminuria or microalbuminuria were classified in class II-a or II-b and <10% in class III; 52% of those with proteinuria were in class II-a, 15% in class II-b, and 19% in class III. Nodular sclerosis (57%) and mesangial expansion (15%) were more frequent in cases with proteinuria than in normoalbuminuria (28% and 8%; P = 0.028 and 0.017). About 20% to 30% of all cases, regardless the level of albuminuria or proteinuria or the histologic class had tubular atrophy, interstitial fibrosis, or inflammation in >10% to 20% of the sample. Moderate hyalinosis and arteriolar sclerosis were observed in 80% to 100% of cases with normoalbuminuria, microalbuminuria, proteinuria, as well as in class I, II, or III. Conclusions: Weak correspondence between analytical parameters and kidney histology was found. Thus, disease may progress undetected from the early clinical stages of the disease. Finally, vascular damage was a very common finding, which highlights the role of ischemic intrarenal disease in diabetes. albuminuria chronic kidney disease diabetes diabetic nephropathy histology normoalbuminuria albuminurija kronična ledvična bolezen diabetes sladkorna bolezen diabetična nefropatija histologija normoalbuminurija true false true Elsevier Angleški jezik Slovenski jezik Znanstveno delo 2024-12-06 10:39:02 2024-12-06 12:04:45 2024-12-07 03:09:47 0000-00-00 00:00:00 2021 0 0 Str. 2392-2403 št. 9 Letn. 6 2021 0000-00-00 Zaloznikova Objavljeno NiDoloceno 2021-05-14 2021-06-04 2021-06-12 616.6 104360707 10.1016/j.ekir.2021.06.001 2468-0249 Rodriguez-Rodri-2021-The_Role_of_Vascular_Lesi.pdf Rodriguez-Rodri-2021-The_Role_of_Vascular_Lesi.pdf 1 902B52F7EBAC7F6983FE7BE73D421C36 b4518ab5af3a0261e76e0d9b03b82a1a0fe1104caa9c72d5ca8a5b476d3a07db 0926501d-b3bc-11ef-aaaf-00155d000105 https://dk.um.si/Dokument.php?lang=slv&id=187177 https://doi.org/10.1016/j.ekir.2021.06.001 1 efb7e9aa-b3b5-11ef-aaaf-00155d000105 https://dk.um.si/Dokument.php?lang=slv&id=187173 Medicinska fakulteta 0 0 0