Impact of primary diabetic nephropathy on arteriolar hyalinosis lesions in patients following kidney transplantation

Autor:	Takafumi, Yamakawa, Akimitsu, Kobayashi, Izumi, Yamamoto, Takehiko, Kawaguchi, Toshiyuki, Imasawa, Hiromichi, Aoyama, Naotake, Akutsu, Michihiro, Maruyama, Kenichi, Saigo, Takashi, Yokoo, Hiroshi, Kitamura
Rok vydání:	2018
Předmět:	Adult Male Hyalin Chi-Square Distribution Time Factors Biopsy Incidence Middle Aged Allografts Kidney Kidney Transplantation Arterioles Logistic Models Treatment Outcome Japan Risk Factors Multivariate Analysis Living Donors Odds Ratio Humans Diabetic Nephropathies Female Vascular Diseases Aged
Zdroj:	Nephrology (Carlton, Vic.). 23
ISSN:	1440-1797
Popis:	Arteriolar hyalinosis (AH) is a common lesion in allograft biopsies taken following kidney transplantation. Recent studies have shown that severe AH may predict transplant outcomes and provide information about previous exposure to certain drugs, such as calcineurin inhibitors (CNI). However, the incidence of AH as a direct result of diabetic nephropathy (DN) after kidney transplantation has not been fully evaluated. This study aimed to assess the impact of primary DN on the development of AH lesions in patients who underwent kidney transplantation.Eighty-three patients who underwent living-donor kidney transplantation between April 2005 and June 2015 were enrolled in this study. A total of 33 patients had DN prior to transplantation. Allograft biopsies were scored according to the Banff classification, and the relationship between the individual histological lesions and clinical baseline data was assessed.At early biopsy (3-12 months), there were no differences in the rates of AH lesions between the DN group and the non-DN group (ah ≥ 1: 37% vs. 41.3%, P = 0.719; aah ≥ 1: 14.8% vs. 6.5%; P = 0.453). However, there were significant differences between the groups in biopsies taken more than 3 years after the transplant (ah ≥ 2: 83.3% vs. 36.8%, P = 0.013; aah ≥ 2: 66.7% vs. 21.1%, P = 0.011). Multivariable analysis showed that both the length of time after transplantation and the presence of DN were independent risk factors for ah ≥ 2 (odds ratio [OR]: 2.55, 95% confidence interval [CI]: 1.47-19.54, P = 0.011) and aah ≥ 2 (OR: 7.55, 95% CI: 1.49-38.33, P = 0.015).This is the first report showing that the presence of primary DN disease contributes to the development of severe AH late in the course after kidney allografts.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=pmid________::80242b69ba80ae1cb6bdf1fab21e1b91 https://pubmed.ncbi.nlm.nih.gov/29968417 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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