Serum hemoglobin concentration and risk of renal function decline in early stages of diabetic kidney disease: a nationwide, biopsy-based cohort study
| Autor: | Yuki Oba, Hirofumi Makino, Daisuke Ikuma, Norihiko Sakai, Miho Shimizu, Tatsuya Suwabe, Takashi Wada, Masayuki Yamanouchi, Yukio Yuzawa, Ken-ichi Samejima, Seiichi Matsuo, Megumi Oshima, Yuta Yamamura, Shinichi Nishi, Tomoya Nishino, Shusaku Matsuoka, Tadashi Toyama, Yoshihiko Ueda, Yoshiki Suzuki, Hiroki Mizuno, Akinori Hara, Yugo Shibagaki, Hiroshi Kitamura, Shinji Kitajima, Yasunori Iwata, Junichi Hoshino, Hiroshi Sato, Noriko Uesugi, Naoki Sawa, Hitoshi Yokoyama, Kentaro Kohagura, Yoshifumi Ubara, Kengo Furuichi |
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| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Anemia Biopsy 030232 urology & nephrology Renal function Kidney Gastroenterology Cohort Studies Hemoglobins 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Diabetes mellitus Internal medicine Renal fibrosis Humans Medicine Diabetic Nephropathies 030212 general & internal medicine Transplantation Creatinine medicine.diagnostic_test business.industry Hazard ratio Middle Aged medicine.disease Diabetes Mellitus Type 2 chemistry Nephrology Disease Progression Female Renal biopsy business Glomerular Filtration Rate Kidney disease |
| Zdroj: | Nephrology Dialysis Transplantation. 37:489-497 |
| ISSN: | 1460-2385 0931-0509 |
| Popis: | Background Prognosticating disease progression in patients with diabetic kidney disease (DKD) is challenging, especially in the early stages of kidney disease. Anemia can occur in the early stages of kidney disease in diabetes. We therefore postulated that serum hemoglobin (Hb) concentration, as a reflection of incipient renal tubulointerstitial impairment, can be used as a marker to predict DKD progression. Methods Drawing on nationally representative data of patients with biopsy-proven DKD, 246 patients who had an estimated glomerular filtration rate (eGFR) ≥60 mL/min/1.73 m2 at renal biopsy were identified: age 56 (45–63) years; 62.6% men; Hb 13.3 (12.0–14.5) g/dL; eGFR 76.2 (66.6–88.6) mL/min/1.73 m2; urine albumin-to-creatinine ratio 534 (100–1480) mg/g Crea. Serum Hb concentration was divided into quartiles: ≤12, 12.1–13.3, 13.4–14.5 and ≥14.6 g/dL. The association between serum Hb concentration and the severity of renal pathological lesions was explored. A multivariable Cox regression model was used to estimate the risk of DKD progression (new onset of end-stage kidney disease, 50% reduction of eGFR or doubling of serum creatinine). The incremental prognostic value of DKD progression by adding serum Hb concentration to the known risk factors of DKD was assessed. Results Serum Hb levels negatively correlated with all renal pathological features, especially with the severity of interstitial fibrosis (ρ = −0.52; P Conclusions Serum Hb concentration, which reflects incipient renal fibrosis, can be useful for predicting DKD progression in the early stages of kidney disease. |
| Databáze: | OpenAIRE |
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