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HOSHINO Junichi
Department School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine Position Professor and Division head |
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| Article types | Original article |
| Language | English |
| Peer review | Non peer reviewed |
| Title | Polar vasculosis is associated with better kidney outcome in type 2 diabetes with biopsy-proven diabetic kidney disease: A multicenter cohort study. |
| Journal | Formal name：Journal of diabetes investigation Abbreviation：J Diabetes Investig ISSN code：20401124/20401116 |
| Volume, Issue, Page | 14(11),pp.1268-1278 |
| Author and coauthor | Shimizu Miho, Furuichi Kengo, Toyama Tadashi, Yamanouchi Masayuki, Hoshino Junichi, Kitajima Shinji, Hara Akinori, Iwata Yasunori, Sakai Norihiko, Yuzawa Yukio, Kitamura Hiroshi, Sato Hiroshi, Shibagaki Yugo, Suzuki Yoshiki, Uesugi Noriko, Ueda Yoshihiko, Kohagura Kentaro, Samejima Kenichi, Tsuruya Kazuhiko, Nishi Shinichi, Nishino Tomoya, Makino Hirofumi, Matsuo Seiichi, Ubara Yoshifumi, Yokoyama Hitoshi, Wada Takashi, |
| Publication date | 2023/11/14 |
| Summary | AIMS/INTRODUCTION:This multicenter cohort study retrospectively assessed the association between polar vasculosis and the progression of diabetic kidney disease (DKD) in type 2 diabetes.MATERIALS AND METHODS:We enrolled 811 patients with type 2 diabetes, biopsy-proven DKD, and proteinuria (≥0.15 g/g creatinine [g/day]). The association between polar vasculosis and other kidney lesions was explored. The outcome was DKD progression defined as a composite of renal replacement therapy initiation or 50% decline in estimated glomerular filtration rate (eGFR) from baseline.RESULTS:Of the 811 cases, 677 (83.5%) had polar vasculosis. In multivariate logistic regression analysis, subendothelial widening of the glomerular basement membrane, glomerulomegaly, glomerular class in the Renal Pathology Society classification ≥IIb, vascular lesions, age, eGFR, and hemoglobin A1c were positively associated with polar vasculosis, whereas interstitial fibrosis and tubular atrophy (IFTA) was negatively associated with polar vasculosis. During a median follow-up of 5.2 years, progression of DKD occurred in 322 of 677 (7.4 events/100 person-years) and 79 of 134 (11.4 events/100 person-years) cases with and without polar vasculosis, respectively. Kaplan-Meier analysis showed that polar vasculosis was associated with lower cumulative incidences of DKD progression. Multivariate Cox regression analyses showed that polar vasculosis was associated with a lower risk of DKD progression, regardless of eGFR or proteinuria subgroups. These associations between polar vasculosis and better kidney outcome were unchanged considering all-cause mortality before DKD progression as a competing event.CONCLUSIONS:This study showed that polar vasculosis of DKD was associated with less advanced IFTA and a better kidney outcome in type 2 diabetes with proteinuria. |
| DOI | 10.1111/jdi.14059 |
| PMID | 37483063 |