Arteriolar hyalinosis is related to rapid GFR decline and long-standing GFR changes observed on renal biopsies in normo-microalbuminuric type 2 diabetic patients
Whether or not renal structural changes, especially arteriolar hyalinosis, are related to the rate of renal functional decline and increase in urinary albumin excretion (UAE) at the early stage of diabetic nephropathy in patients with type 2 diabetes is still unknown. Our previous study determined t...
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| Veröffentlicht in: | Journal of diabetes and its complications 2021-04, Vol.35 (4), p.107847, Article 107847 |
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| creator | Moriya, Tatsumi Yamagishi, Takahiro Yoshida, Yuki Matsubara, Madoka Ouchi, Motoshi |
| description | Whether or not renal structural changes, especially arteriolar hyalinosis, are related to the rate of renal functional decline and increase in urinary albumin excretion (UAE) at the early stage of diabetic nephropathy in patients with type 2 diabetes is still unknown. Our previous study determined that arteriolar hyalinosis is an independent risk factor for low GFR. We sought to determine whether arteriolar hyalinosis is also a risk factor for rapidly progressive decline in GFR.
We evaluated 22 type 2 diabetic patients with normo- or microalbuminuria who took part in the previous study, to clarify which renal histological factors were associated with changes in UAE and the glomerular filtration rate (GFR) during 11.0 ± 3.0 years of follow-up. Light and electron microscopy-based morphometric analyses were performed to quantitatively evaluate the glomerular and interstitial structural changes.
In all 22 patients, the GFR was significantly decreased from baseline to follow-up, while the UAE did not change markedly between the 2 periods. After 11 ± 3 years of follow-up, the GFR was significantly lower in the rapid decliner group (annual rate of GFR decline ≥3.0%) than in the non-rapid decliner group (p = 0.017). The index of arteriolar hyalinosis (IAH) at baseline in the rapid decliners was significantly larger than in the non-rapid decliners (p = 0.015). The IAH showed a significant negative correlation with the GFR at follow-up (r = 0.50, p = 0.018) and the annual rate in the GFR decline (r = 0.47, p = 0.027) and significant positive correlations with UAE at follow-up (r = 0.46, p = 0.034) and the annual rate in the UAE increase (r = 0.57, p = 0.005). The GFR at follow-up in patients with IAH ≥2.0 was significantly decreased from baseline (p = 0.042) and significantly lower than that of the patients with IAH |
| doi_str_mv | 10.1016/j.jdiacomp.2021.107847 |
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We evaluated 22 type 2 diabetic patients with normo- or microalbuminuria who took part in the previous study, to clarify which renal histological factors were associated with changes in UAE and the glomerular filtration rate (GFR) during 11.0 ± 3.0 years of follow-up. Light and electron microscopy-based morphometric analyses were performed to quantitatively evaluate the glomerular and interstitial structural changes.
In all 22 patients, the GFR was significantly decreased from baseline to follow-up, while the UAE did not change markedly between the 2 periods. After 11 ± 3 years of follow-up, the GFR was significantly lower in the rapid decliner group (annual rate of GFR decline ≥3.0%) than in the non-rapid decliner group (p = 0.017). The index of arteriolar hyalinosis (IAH) at baseline in the rapid decliners was significantly larger than in the non-rapid decliners (p = 0.015). The IAH showed a significant negative correlation with the GFR at follow-up (r = 0.50, p = 0.018) and the annual rate in the GFR decline (r = 0.47, p = 0.027) and significant positive correlations with UAE at follow-up (r = 0.46, p = 0.034) and the annual rate in the UAE increase (r = 0.57, p = 0.005). The GFR at follow-up in patients with IAH ≥2.0 was significantly decreased from baseline (p = 0.042) and significantly lower than that of the patients with IAH <2.0 (p = 0.026), which did not decrease significantly from baseline. The frequency of rapid decliners was larger in the IAH ≥2.0 than in the IAH <2.0 patients (p = 0.037).
Aggravated arteriolar hyalinosis was a risk factor for a rapid GFR decline. This finding might reflect initial changes in early diabetic nephropathy.
•The present study investigated the relationship of renal arteriolar hyalinosis and rapid GFR decline in normo-microalbuminuric type 2 diabetes patients based on renal biopsy results.•The index of arteriolar hyalinosis (IAH) in the rapid GFR decliners was significantly larger than in the non-rapid decliners.•The IAH showed significant negative correlations with the annual rate of GFR decline and significant positive correlations with the annual rate of UAE increase.•Aggravated arteriolar hyalinosis was a risk factor for a rapid GFR decline and an initial change in early diabetic nephropathy.</description><identifier>ISSN: 1056-8727</identifier><identifier>EISSN: 1873-460X</identifier><identifier>DOI: 10.1016/j.jdiacomp.2021.107847</identifier><identifier>PMID: 33468395</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Albumins ; Albuminuria - complications ; Antihypertensives ; Arteriolar hyalinosis ; Biopsy ; Diabetes ; Diabetes Mellitus, Type 2 - complications ; Diabetic Nephropathies - diagnosis ; Diabetic Nephropathies - epidemiology ; Diabetic nephropathy ; Diabetic retinopathy ; Glomerular Filtration Rate ; Humans ; Hypertension ; Laboratories ; Microscopy ; Morphology ; Rapid GFR decline ; Renal biopsy ; Renal pathology ; Values</subject><ispartof>Journal of diabetes and its complications, 2021-04, Vol.35 (4), p.107847, Article 107847</ispartof><rights>2021 Elsevier Inc.</rights><rights>Copyright © 2021 Elsevier Inc. All rights reserved.</rights><rights>2021. Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c462t-284ad51e613c50f61c988275ad338eed36d16649f3e816f3d024da5f2c9314b63</citedby><cites>FETCH-LOGICAL-c462t-284ad51e613c50f61c988275ad338eed36d16649f3e816f3d024da5f2c9314b63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/2494865167?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995,64385,64389,72469</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33468395$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Moriya, Tatsumi</creatorcontrib><creatorcontrib>Yamagishi, Takahiro</creatorcontrib><creatorcontrib>Yoshida, Yuki</creatorcontrib><creatorcontrib>Matsubara, Madoka</creatorcontrib><creatorcontrib>Ouchi, Motoshi</creatorcontrib><title>Arteriolar hyalinosis is related to rapid GFR decline and long-standing GFR changes observed on renal biopsies in normo-microalbuminuric type 2 diabetic patients</title><title>Journal of diabetes and its complications</title><addtitle>J Diabetes Complications</addtitle><description>Whether or not renal structural changes, especially arteriolar hyalinosis, are related to the rate of renal functional decline and increase in urinary albumin excretion (UAE) at the early stage of diabetic nephropathy in patients with type 2 diabetes is still unknown. Our previous study determined that arteriolar hyalinosis is an independent risk factor for low GFR. We sought to determine whether arteriolar hyalinosis is also a risk factor for rapidly progressive decline in GFR.
We evaluated 22 type 2 diabetic patients with normo- or microalbuminuria who took part in the previous study, to clarify which renal histological factors were associated with changes in UAE and the glomerular filtration rate (GFR) during 11.0 ± 3.0 years of follow-up. Light and electron microscopy-based morphometric analyses were performed to quantitatively evaluate the glomerular and interstitial structural changes.
In all 22 patients, the GFR was significantly decreased from baseline to follow-up, while the UAE did not change markedly between the 2 periods. After 11 ± 3 years of follow-up, the GFR was significantly lower in the rapid decliner group (annual rate of GFR decline ≥3.0%) than in the non-rapid decliner group (p = 0.017). The index of arteriolar hyalinosis (IAH) at baseline in the rapid decliners was significantly larger than in the non-rapid decliners (p = 0.015). The IAH showed a significant negative correlation with the GFR at follow-up (r = 0.50, p = 0.018) and the annual rate in the GFR decline (r = 0.47, p = 0.027) and significant positive correlations with UAE at follow-up (r = 0.46, p = 0.034) and the annual rate in the UAE increase (r = 0.57, p = 0.005). The GFR at follow-up in patients with IAH ≥2.0 was significantly decreased from baseline (p = 0.042) and significantly lower than that of the patients with IAH <2.0 (p = 0.026), which did not decrease significantly from baseline. The frequency of rapid decliners was larger in the IAH ≥2.0 than in the IAH <2.0 patients (p = 0.037).
Aggravated arteriolar hyalinosis was a risk factor for a rapid GFR decline. This finding might reflect initial changes in early diabetic nephropathy.
•The present study investigated the relationship of renal arteriolar hyalinosis and rapid GFR decline in normo-microalbuminuric type 2 diabetes patients based on renal biopsy results.•The index of arteriolar hyalinosis (IAH) in the rapid GFR decliners was significantly larger than in the non-rapid decliners.•The IAH showed significant negative correlations with the annual rate of GFR decline and significant positive correlations with the annual rate of UAE increase.•Aggravated arteriolar hyalinosis was a risk factor for a rapid GFR decline and an initial change in early diabetic nephropathy.</description><subject>Albumins</subject><subject>Albuminuria - complications</subject><subject>Antihypertensives</subject><subject>Arteriolar hyalinosis</subject><subject>Biopsy</subject><subject>Diabetes</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>Diabetic Nephropathies - diagnosis</subject><subject>Diabetic Nephropathies - epidemiology</subject><subject>Diabetic nephropathy</subject><subject>Diabetic retinopathy</subject><subject>Glomerular Filtration Rate</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Laboratories</subject><subject>Microscopy</subject><subject>Morphology</subject><subject>Rapid GFR decline</subject><subject>Renal biopsy</subject><subject>Renal pathology</subject><subject>Values</subject><issn>1056-8727</issn><issn>1873-460X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFUdtq3TAQFKWlSdP-QhD02ae6WZbfGkJzgUChNNA3IUvrExlbciU5cD6nf1olJ-lrQbCr3ZnRrgahc0p2lFD5ZdpNzhsbl3XHCKO12CnRvUGnVHW8EZL8eltz0spGdaw7QR9yngghsm3pe3TCuZCK9-0p-nORCiQfZ5Pww8HMPsTsM64nwWwKOFwiTmb1Dl9f_cAObIUANsHhOYZ9k0tNfdg_d-2DCXvIOA4Z0mPlxlBlgpnx4OOafW35gENMS2wWb1M087AtPmzJW1wOK2CG61YDlHpfTfEQSv6I3o1mzvDpJZ6h-6tvPy9vmrvv17eXF3eNFZKVhilhXEtBUm5bMkpqe6VY1xrHuQJwXDoqpehHDorKkTvChDPtyGzPqRgkP0Ofj7prir83yEVPcUt1-KyZ6IWSLZVdRckjqk6fc4JRr8kvJh00JfrJGT3pV2f0kzP66Ewlnr_Ib8MC7h_t1YoK-HoEQF3y0UPS2dYPsOB8Alu0i_5_b_wFLOqk9Q</recordid><startdate>202104</startdate><enddate>202104</enddate><creator>Moriya, Tatsumi</creator><creator>Yamagishi, Takahiro</creator><creator>Yoshida, Yuki</creator><creator>Matsubara, Madoka</creator><creator>Ouchi, Motoshi</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>ASE</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FPQ</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K6X</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope></search><sort><creationdate>202104</creationdate><title>Arteriolar hyalinosis is related to rapid GFR decline and long-standing GFR changes observed on renal biopsies in normo-microalbuminuric type 2 diabetic patients</title><author>Moriya, Tatsumi ; Yamagishi, Takahiro ; Yoshida, Yuki ; Matsubara, Madoka ; Ouchi, Motoshi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c462t-284ad51e613c50f61c988275ad338eed36d16649f3e816f3d024da5f2c9314b63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Albumins</topic><topic>Albuminuria - complications</topic><topic>Antihypertensives</topic><topic>Arteriolar hyalinosis</topic><topic>Biopsy</topic><topic>Diabetes</topic><topic>Diabetes Mellitus, Type 2 - complications</topic><topic>Diabetic Nephropathies - diagnosis</topic><topic>Diabetic Nephropathies - epidemiology</topic><topic>Diabetic nephropathy</topic><topic>Diabetic retinopathy</topic><topic>Glomerular Filtration Rate</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Laboratories</topic><topic>Microscopy</topic><topic>Morphology</topic><topic>Rapid GFR decline</topic><topic>Renal biopsy</topic><topic>Renal pathology</topic><topic>Values</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Moriya, Tatsumi</creatorcontrib><creatorcontrib>Yamagishi, Takahiro</creatorcontrib><creatorcontrib>Yoshida, Yuki</creatorcontrib><creatorcontrib>Matsubara, Madoka</creatorcontrib><creatorcontrib>Ouchi, Motoshi</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>British Nursing Index</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>British Nursing Index</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><jtitle>Journal of diabetes and its complications</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Moriya, Tatsumi</au><au>Yamagishi, Takahiro</au><au>Yoshida, Yuki</au><au>Matsubara, Madoka</au><au>Ouchi, Motoshi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Arteriolar hyalinosis is related to rapid GFR decline and long-standing GFR changes observed on renal biopsies in normo-microalbuminuric type 2 diabetic patients</atitle><jtitle>Journal of diabetes and its complications</jtitle><addtitle>J Diabetes Complications</addtitle><date>2021-04</date><risdate>2021</risdate><volume>35</volume><issue>4</issue><spage>107847</spage><pages>107847-</pages><artnum>107847</artnum><issn>1056-8727</issn><eissn>1873-460X</eissn><abstract>Whether or not renal structural changes, especially arteriolar hyalinosis, are related to the rate of renal functional decline and increase in urinary albumin excretion (UAE) at the early stage of diabetic nephropathy in patients with type 2 diabetes is still unknown. Our previous study determined that arteriolar hyalinosis is an independent risk factor for low GFR. We sought to determine whether arteriolar hyalinosis is also a risk factor for rapidly progressive decline in GFR.
We evaluated 22 type 2 diabetic patients with normo- or microalbuminuria who took part in the previous study, to clarify which renal histological factors were associated with changes in UAE and the glomerular filtration rate (GFR) during 11.0 ± 3.0 years of follow-up. Light and electron microscopy-based morphometric analyses were performed to quantitatively evaluate the glomerular and interstitial structural changes.
In all 22 patients, the GFR was significantly decreased from baseline to follow-up, while the UAE did not change markedly between the 2 periods. After 11 ± 3 years of follow-up, the GFR was significantly lower in the rapid decliner group (annual rate of GFR decline ≥3.0%) than in the non-rapid decliner group (p = 0.017). The index of arteriolar hyalinosis (IAH) at baseline in the rapid decliners was significantly larger than in the non-rapid decliners (p = 0.015). The IAH showed a significant negative correlation with the GFR at follow-up (r = 0.50, p = 0.018) and the annual rate in the GFR decline (r = 0.47, p = 0.027) and significant positive correlations with UAE at follow-up (r = 0.46, p = 0.034) and the annual rate in the UAE increase (r = 0.57, p = 0.005). The GFR at follow-up in patients with IAH ≥2.0 was significantly decreased from baseline (p = 0.042) and significantly lower than that of the patients with IAH <2.0 (p = 0.026), which did not decrease significantly from baseline. The frequency of rapid decliners was larger in the IAH ≥2.0 than in the IAH <2.0 patients (p = 0.037).
Aggravated arteriolar hyalinosis was a risk factor for a rapid GFR decline. This finding might reflect initial changes in early diabetic nephropathy.
•The present study investigated the relationship of renal arteriolar hyalinosis and rapid GFR decline in normo-microalbuminuric type 2 diabetes patients based on renal biopsy results.•The index of arteriolar hyalinosis (IAH) in the rapid GFR decliners was significantly larger than in the non-rapid decliners.•The IAH showed significant negative correlations with the annual rate of GFR decline and significant positive correlations with the annual rate of UAE increase.•Aggravated arteriolar hyalinosis was a risk factor for a rapid GFR decline and an initial change in early diabetic nephropathy.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>33468395</pmid><doi>10.1016/j.jdiacomp.2021.107847</doi></addata></record> |
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| subjects | Albumins Albuminuria - complications Antihypertensives Arteriolar hyalinosis Biopsy Diabetes Diabetes Mellitus, Type 2 - complications Diabetic Nephropathies - diagnosis Diabetic Nephropathies - epidemiology Diabetic nephropathy Diabetic retinopathy Glomerular Filtration Rate Humans Hypertension Laboratories Microscopy Morphology Rapid GFR decline Renal biopsy Renal pathology Values |
| title | Arteriolar hyalinosis is related to rapid GFR decline and long-standing GFR changes observed on renal biopsies in normo-microalbuminuric type 2 diabetic patients |
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