Clinicopathological Features and Outcomes of Nondiabetic Renal Disease in Patients with Type 2 Diabetes: A Retrospective Cohort Study.
This study evaluated the clinicopathological profiles and prognostic trajectories of nondiabetic renal disease (NDRD) subtypes coexisting with type 2 diabetes mellitus (T2D).
The study cohort comprised of 123 patients with predominant NDRD subtypes: IgA nephropathy (T2D-IgAN, n = 52), membranous nephropathy (T2D-MN, n = 48), and podocytopathies (T2D-Podo, n = 23). Multivariate Cox regression was used to identify prognostic factors for renal outcomes over a median follow-up period of 80 months (interquartile range 62-102).
T2D-MN patients exhibited distinct characteristics compared to T2D-IgAN and T2D-Podo, including advanced age, higher incidence of nephrotic-range proteinuria and elevated total cholesterol. This group also demonstrated a greater susceptibility to atherosclerotic plaque formation. Pathological analysis revealed more severe glomerular sclerosis, interstitial inflammation, and C3 deposition in T2D-IgAN. Multivariate Cox regression identified three independent predictors of renal endpoints: glomerular C3 deposition (HR 3.021, 95% CI: 1.084-8.419), preserved estimated glomerular filtration rate (>60 mL/min/1.73 m2; HR 0.296, 95% CI: 0.110-0.796), and prolonged T2D duration (>10 years; HR 4.168, 95% CI: 1.389-12.503).
These findings suggest that integrating clinical and pathological parameters enhances the prognostic accuracy of NDRD in patients with diabetes, enabling timely therapeutic interventions to mitigate complications in high-risk cases.
The study cohort comprised of 123 patients with predominant NDRD subtypes: IgA nephropathy (T2D-IgAN, n = 52), membranous nephropathy (T2D-MN, n = 48), and podocytopathies (T2D-Podo, n = 23). Multivariate Cox regression was used to identify prognostic factors for renal outcomes over a median follow-up period of 80 months (interquartile range 62-102).
T2D-MN patients exhibited distinct characteristics compared to T2D-IgAN and T2D-Podo, including advanced age, higher incidence of nephrotic-range proteinuria and elevated total cholesterol. This group also demonstrated a greater susceptibility to atherosclerotic plaque formation. Pathological analysis revealed more severe glomerular sclerosis, interstitial inflammation, and C3 deposition in T2D-IgAN. Multivariate Cox regression identified three independent predictors of renal endpoints: glomerular C3 deposition (HR 3.021, 95% CI: 1.084-8.419), preserved estimated glomerular filtration rate (>60 mL/min/1.73 m2; HR 0.296, 95% CI: 0.110-0.796), and prolonged T2D duration (>10 years; HR 4.168, 95% CI: 1.389-12.503).
These findings suggest that integrating clinical and pathological parameters enhances the prognostic accuracy of NDRD in patients with diabetes, enabling timely therapeutic interventions to mitigate complications in high-risk cases.
Authors
Zhou Zhou, Liu Liu, Li Li, Feng Feng, Zhang Zhang, Wang Wang, Jiao Jiao, Fan Fan
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