Differential impact of glomerular and tubule-interstitial histological changes on kidney outcome between non-proteinuric and proteinuric diabetic nephropathy

• Material Type: 博士論文
• Title: Differential impact of glomerular and tubule-interstitial histological changes on kidney outcome between non-proteinuric and proteinuric diabetic nephropathy
• Author/Editor: Fukata, Fumihiro; Eriguchi, Masahiro; Tamaki, Hiroyuki; Uemura, Takayuki; Tasaki, Hikari; Furuyama, Riri; Nishimoto, Masatoshi; Kosugi, Takaaki; Tanabe, Kaori; Morimoto, Katsuhiko; Okamoto, Keisuke; Matsui, Masaru; Samejima, Kenichi; Tsuruya, Kazuhiko
• Author Heading: Fukata, Fumihiro; Eriguchi, Masahiro; Tamaki, Hiroyuki; Uemura, Takayuki; Tasaki, Hikari; Furuyama, Riri; Nishimoto, Masatoshi; Kosugi, Takaaki; Tanabe, Kaori; Morimoto, Katsuhiko; Okamoto, Keisuke; Matsui, Masaru; Samejima, Kenichi; Tsuruya, Kazuhiko
• Publication, Distribution, etc.: Springer
• Publication Date: 2024-04
• Publication Date (W3CDTF): 2024-04
• Alternative Title: 糖尿病性腎症における，尿蛋白量と，糸球体および尿細管間質の組織学的変化が腎予後に与える影響の関連性
• Periodical title: Clinical and Experimental Nephrology
• No. or year of volume/issue: 28 4
• Volume: 28
• Issue: 4
• Pages: 282-292
• ISSN (Periodical Title): ISSN : 1342-1751
• Degree grantor/type: 奈良県立医科大学
• Date Granted: 2024-03-14
• Dissertation Number: 甲第910号
• Degree Type: 博士（医学）
• Text Language Code: eng
• Subject Heading: Diabetic nephropathy; glomerular lesion; interstitial fibrosis and tubular atrophy; kidney outcome
• Target Audience: 一般
• Note (General): type:Thesis; Background: Studies 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. Methods: Patients 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. Results: The 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). Conclusions: IFTA 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.; 権利情報：© The Author(s), under exclusive licence to Japanese Society of Nephrology 2023. This version of the article has been accepted for publication, after peer review (when applicable) and is subject to Springer Nature’s AM terms of use, but is not the Version of Record and does not reflect post-acceptance improvements, or any corrections. The Version of Record is available online at: https://doi.org/10.1007/s10157-023-02433-y; identifier:Clinical and Experimental Nephrology. 2024 Apr, vol.28, no.4, p.282-292; identifier:1342-1751; identifier:http://ginmu.naramed-u.ac.jp/dspace/handle/10564/4361; identifier:Clinical and Experimental Nephrology, 28(4): 282-292
• Source: fulltext; http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/4361/1/01%e7%94%b2910%e6%9c%ac%e6%96%87.pdf; http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/4361/2/02%e7%94%b2910%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdf; http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/4361/3/03%e7%94%b2910%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdf; http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/4361/4/04%e7%94%b2910Figure.pdf; http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/4361/5/05%e7%94%b2910Supplemental%20materials.pdf
• Access Restrictions: インターネット公開
• Related Material (DOI): 10.1007/s10157-023-02433-y
• Periodical Title (NCID): AA11126935; https://ci.nii.ac.jp/ncid/AA11126935
• Data Provider (Database): 国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）; https://irdb.nii.ac.jp
• Original Data Provider (Database): 奈良県立医科大学 : 奈良県立医科大学機関リポジトリ GINMU