| Histological predictors for renal prognosis in diabetic nephropathy in type 2 diabetes patients with overt proteinuria. | |
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MedLine Citation:
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PMID: 21933307 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Background: Although several clinical risk factors for end-stage renal disease in diabetic nephropathy are known, the pathological findings which may help predict renal prognosis have not yet been defined. Patients and methods: We enrolled 69 type 2 diabetes patients with overt proteinuria and biopsy-confirmed diabetic nephropathy with mesangial expansion, and retrospectively examined the association of histological and clinical findings with renal outcome. The median follow-up duration was 52 months. Histological scoring was made according to that of Tervaert et al. Patients were divided into 4 groups according to glomerular classification (class 2a, mild mesangial expansion, n = 11; class 2b, severe mesangial expansion without nodular sclerosis, n = 15; class 3, nodular sclerosis, n = 36; class 4, global glomerulosclerosis observed in more than 50% of glomeruli, n = 7). Interstitial and vascular lesions were scored for each patient. A renal event was defined as a condition requiring the initiation of chronic dialysis or doubling of the serum creatinine level. Results: Cox proportional hazard analysis showed that the glomerular classes were not significant variables, while interstitial fibrosis, tubular atrophy and interstitial inflammation were independent variables associated with renal end-point (HR: 3.36 (95% confidence interval: 1.21-9.32), 4.74 (1.26-17.91)). There were no significant differences in the renal survival rates between the glomerular classes 2a and 2b combined group and the glomerular class 3 group (p = 0.17, log-rank test). Conclusion: Interstitial lesions but not glomerular lesions were a significant predictor for renal prognosis in diabetic nephropathy in type 2 diabetes patients with overt proteinuria. |
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Authors:
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Tomonari Okada; Toshitaka Nagao; Hiroshi Matsumoto; Yume Nagaoka; Toshikazu Wada; Toshiyuki Nakao |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-9-20 |
Journal Detail:
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Title: Nephrology (Carlton, Vic.) Volume: - ISSN: 1440-1797 ISO Abbreviation: - Publication Date: 2011 Sep |
Date Detail:
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Created Date: 2011-9-21 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9615568 Medline TA: Nephrology (Carlton) Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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© 2011 The Authors. Nephrology © 2011 Asian Pacific Society of Nephrology. |
Affiliation:
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Departments of Nephrology and Anatomic Pathology Tokyo Medical University, Tokyo, Japan. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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