ArticleClinical and experimental nephrology2024
Differential impact of glomerular and tubule-interstitial histological changes on kidney outcome between non-proteinuric and proteinuric diabetic nephropathy.
Article in Clinical and experimental nephrology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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5 citing papers in PubMed, 3 citations in OpenAlex.
- Fractional Excretion of Total Protein and Long-Term Kidney Outcomes in Patients With Biopsy-Proven Diabetic Nephropathy: The N-BDN Study.Diabetes, obesity & metabolism · 2026Observational
- Prognostic significance of interstitial fibrosis and tubular atrophy in biopsy-proven diabetic kidney disease: a single-center retrospective cohort study.Frontiers in endocrinology · 2026Article
- New interpretation of diabetic nephropathy or diabetic kidney disease from kidney biopsy: review article.Clinical and experimental nephrology · 2025Review
- Shenyuan granules improve cellular senescence through Klotho-mediated p16/p21 signaling pathway in diabetic kidney disease.Frontiers in medicine · 2025Article
- Interstitial Fibrosis and Tubular Atrophy as a Predictor of Renal Outcomes in Patients with Malignant Hypertension-Related Thrombotic Microangiopathy: A Multicentric Cohort Study.Kidney diseases (Basel, Switzerland)Article
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14 authors at 2 institutions in 1 country.
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Abstract
backgroundStudies on kidney function and histological findings in diabetic nephropathy (DN) with low urinary protein (UP) are few. We examined the differential impact of histological changes on kidney outcomes between non-proteinuric and proteinuric DN.
methodsPatients diagnosed with DN by renal biopsy during 1981-2014 were divided into non-proteinuric (UP ≤ 0.5 g/day) and proteinuric (UP > 0.5 g/day) DN. The Cox proportional hazard model was used to examine the association of glomerular lesions (GLs) and interstitial fibrosis and tubular atrophy (IFTA) with end-stage kidney disease (ESKD) development after adjusting for relevant confounders.
resultsThe non-proteinuric and proteinuric DN groups included 197 and 199 patients, respectively. During the 10.7-year median follow-up period, 16 and 83 patients developed ESKD in the non-proteinuric and proteinuric DN groups, respectively. In the multivariable Cox hazard model, hazard ratios (HRs) [95% confidence intervals (CIs)] of GL and IFTA for ESKD in proteinuric DN were 2.94 [1.67-5.36] and 3.82 [2.06-7.53], respectively. Meanwhile, HRs [95% CIs] of GL and IFTA in non-proteinuric DN were < 0.01 [0-2.48] and 4.98 [1.33-18.0], respectively. IFTA was consistently associated with higher incidences of ESKD regardless of proteinuria levels (P for interaction = 0.49). The prognostic impact of GLs on ESKD was significantly decreased as proteinuria levels decreased (P for interaction < 0.01).
conclusionsIFTA is consistently a useful predictor of kidney prognosis in both non-proteinuric and proteinuric DN, while GLs are a significant predictor of kidney prognosis only in proteinuric DN.
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