Combining glomerular basement membrane and tubular basement membrane assessment improves the prediction of diabetic end-stage renal disease.

Abstract:

BACKGROUND:To address the prognostic value of combining tubular basement membrane (TBM) and glomerular basement membrane (GBM) thickness in diabetic nephropathy (DN). METHODS:This retrospective study enrolled 110 patients with type 2 diabetes and biopsy-proven DN from 2011 to 2018. The pathological findings were confirmed according to the Renal Pathology Society classifications. GBM and TBM thicknesses were determined using the Haas' direct measurement/arithmetic mean method and orthogonal intercept method, respectively. Cox proportional hazard models were used to investigate the hazard ratios (HRs) for the influence of combined GBM and TBM thickness for predicting end-stage renal disease (ESRD). RESULTS:Patients were assigned to three groups according to the median GBM and TBM thickness: GBMlo TBMlo (GBM < 681 nm and TBM < 1200 nm), GBMhi TBMlo /GBMlo TBMhi (GBM ≥ 681 nm and TBM < 1200 nm, or GBM < 681 nm and TBM ≥ 1200 nm), and GBMhi TBMhi (GBM ≥ 681 nm and TBM ≥ 1200 nm). The GBMhi TBMlo /GBMlo TBMhi and GBMhi TBMhi groups displayed poorer renal function, a more severe glomerular classification and interstitial inflammation, and poorer renal survival rates than the GBMlo TBMlo group The GBMhi TBMlo /GBMlo TBMhi and GBMhi TBMhi groups had adjusted HRs of 1.49 (95% confidence interval [CI], 1.21-9.75) and 3.07 (95% CI, 2.87-12.78), respectively, compared with the GBMlo TBMlo group. CONCLUSIONS:TBM thickness enhanced GBM thickness for renal prognosis in patients with type 2 diabetes.

journal_name

J Diabetes

journal_title

Journal of diabetes

authors

Zhao L,Zhang J,Lei S,Ren H,Zou Y,Bai L,Zhang R,Xu H,Li L,Zhao Y,Cooper ME,Tong N,Zhang J,Liu F

doi

10.1111/1753-0407.13150

subject

Has Abstract

pub_date

2020-12-22 00:00:00

eissn

1753-0393

issn

1753-0407

pub_type

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