Show simple item record

dc.contributor.authorEkinci, EI
dc.contributor.authorJerums, G
dc.contributor.authorSkene, A
dc.contributor.authorCrammer, P
dc.contributor.authorPower, D
dc.contributor.authorCheong, KY
dc.contributor.authorPanagiotopoulos, S
dc.contributor.authorMcNeil, K
dc.contributor.authorBaker, ST
dc.contributor.authorFioretto, P
dc.contributor.authorMacIsaac, RJ
dc.date.available2019-02-08T02:53:22Z
dc.date.issued2013-11-01
dc.identifierpii: dc12-2572
dc.identifier.citationEkinci, E. I., Jerums, G., Skene, A., Crammer, P., Power, D., Cheong, K. Y., Panagiotopoulos, S., McNeil, K., Baker, S. T., Fioretto, P. & MacIsaac, R. J. (2013). Renal Structure in Normoalbuminuric and Albuminuric Patients With Type 2 Diabetes and Impaired Renal Function. DIABETES CARE, 36 (11), pp.3620-3626. https://doi.org/10.2337/dc12-2572.
dc.identifier.issn0149-5992
dc.identifier.urihttp://hdl.handle.net/11343/220517
dc.description.abstractOBJECTIVE: The structural basis of normoalbuminuric renal insufficiency in patients with type 2 diabetes remains to be elucidated. We compared renal biopsy findings in patients with type 2 diabetes and estimated glomerular filtration rate (eGFR) and measured GFR of <60 mL/min/1.73 m2, associated with either normo-, micro-, or macroalbuminuria. RESEARCH DESIGN AND METHODS: In patients with normo- (n = 8) or microalbuminuria (n = 6), renal biopsies were performed according to a research protocol. In patients with macroalbuminuria (n = 17), biopsies were performed according to clinical indication. Findings were categorized according to the Fioretto classification: category 1 (C1), normal/near normal; category 2 (C2), typical diabetic nephropathy (DN) with predominantly glomerular changes; and category 3 (C3), atypical with disproportionately severe interstitial/tubular/vascular damage and with no/mild diabetic glomerular changes. RESULTS: In our study population (mean eGFR 35 mL/min/1.73 m2), typical glomerular changes (C2) of DN were observed in 22 of 23 subjects with micro- or macroalbuminuria compared with 3 of 8 subjects with normoalbuminuria (P = 0.002). By contrast, predominantly interstitial or vascular changes (C3) were seen in only 1 of 23 subjects with micro- or macroalbuminuria compared with 3 of 8 normoalbuminuric subjects (P = 0.08). Mesangial area increased progressively from normal controls to patients with type 2 diabetes and normo-, micro-, and macroalbuminuria. Varying degrees of arteriosclerosis, although not necessarily the predominant pattern, were seen in seven of eight subjects with normoalbuminuria. CONCLUSIONS: Typical renal structural changes of DN were observed in patients with type 2 diabetes and elevated albuminuria. By contrast, in normoalbuminuric renal insufficiency, these changes were seen less frequently, likely reflecting greater contributions from aging, hypertension, and arteriosclerosis.
dc.languageEnglish
dc.publisherAMER DIABETES ASSOC
dc.titleRenal Structure in Normoalbuminuric and Albuminuric Patients With Type 2 Diabetes and Impaired Renal Function
dc.typeJournal Article
dc.identifier.doi10.2337/dc12-2572
melbourne.affiliation.departmentCentre for Cancer Research
melbourne.affiliation.departmentMedicine, Dentistry & Health Sciences
melbourne.affiliation.departmentClinical School (Austin Health)
melbourne.affiliation.departmentMedicine (Austin & Northern Health)
melbourne.affiliation.departmentMedicine (St Vincent's)
melbourne.source.titleDIABETES CARE
melbourne.source.volume36
melbourne.source.issue11
melbourne.source.pages3620-3626
dc.rights.licenseCC BY-NC-ND
melbourne.elementsid589961
melbourne.openaccess.pmchttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC3816854
melbourne.contributor.authorEkinci, Elif
melbourne.contributor.authorJerums, George
melbourne.contributor.authorPower, David
melbourne.contributor.authorPanagiotopoulos, Sianna
melbourne.contributor.authorMacIsaac, Richard
melbourne.contributor.authorCheong, Karey
melbourne.contributor.authorMCNEIL, KAREN
melbourne.contributor.authorBAKER, SCOTT
dc.identifier.eissn1935-5548
melbourne.conference.locationUnited States
melbourne.accessrightsOpen Access


Files in this item

Thumbnail

This item appears in the following Collection(s)

Show simple item record