ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on X

Kidney Week

ASN / Education & Meetings / Kidney Week /

Please note that you are viewing an archived section from 2019 and some content may be unavailable. To unlock all content for 2019, please visit the archives.

Abstract: SA-PO540

Interstitial Eosinophilic Infiltration in Diabetic Nephropathy Is Indicative of Poor Prognosis with No Therapy Benefit from Steroid

Session Information

Category: Diabetic Kidney Disease

  • 602 Diabetic Kidney Disease: Clinical

Authors

  • Wu, Wenyan, Peking University First Hospital, Beijing, China
  • Zhou, Xujie, Peking University First Hospital, Beijing, China
  • Sun, Pingping, Peking University First Hospital, Beijing, China
  • Xiaojuan, Yu, Peking University First Hospital, Beijing, China
  • Wang, Su-xia, Peking University First Hospital, Beijing, China
  • Qu, Lane, Peking University First Hospital, Beijing, China
  • Zhang, Fan, Peking University First Hospital, Beijing, China
  • Ma, Yi, Peking University First Hospital, Beijing, China
  • Liu, Gang, Peking University First Hospital, Beijing, China
  • Yang, Li, Peking University First Hospital, Beijing, China
Background

Recent data suggested that eosinophils in diabetes might be associated with severity of diabetic nephropathy (DN). In a retrospective study of 102 Chinese patients with biopsy proven DN, we aimed to evaluate relationships of both blood and renal eosinophils(Eos) to the severity of DN, and check whether it can be served as an independent indicator of prognosis as well as therapeutic effect of steroids in these patients.

Methods

A total of 102 patients with a single diagnosis of glomerulopathy with DN were enrolled. Demographical and clinical data as well as histopathological scores were associated. Interstitial eosinophilic aggregates (IEA) were defined as the presence of ≥10 Eos in at least one high-power field (×400). End stage renal disease was defined as the end point. Urinary eosinophil cationic protein (ECP) levels were also analyzed to evaluate its biomarker role in DN

Results

We observed that log2(blood eosinophil counts) correlated with neutrophil counts, proteinuria and interstitial inflammation. IEA was observed in 33.3% of the DN patients and was associated with higher serum creatinine (2.3 vs. 1.5mg/dL, p=0.021), lower estimated glomerular filtration rate (39.8 ± 27.3 vs. 51.9 ± 30.3ml/min/1.73 m2, p=0.053), higher proteinuria (7.5 ± 4.8 vs. 4.9 ± 3.6g/d, p=0.004), more prevalence of hematuria (82.4% vs. 43.9%, p<0.001), higher HbA1c (7.5 ± 1.9% vs. 6.7 ± 1.4%, p=0.026), higher blood eosinophil counts (0.22 × 109vs. 0.16 × 109/L, p=0.001), severer tubulointerstitial injury including tubular injury (p=0.004), interstitial inflammation(p=0.004), tubular atrophy (p= 0.007) and interstitial fibrosis (p=0.020). IEA was associated with worse renal prognosis (HR 2.424, p=0.008). Consistently, urine ECP (ng/mgCr) was associated with renal injury and poor renal prognosis (HR 1.160, p=0.024). Patients with IEA were more likely to be treated with steroid (IEA vs. non-IEA, 47.1% vs. 14.7%, p=0.001) but did not show renal benefit.

Conclusion

It suggested that both blood and renal infiltrated eosinophils were prevalent in DN and associated with severity of DN. But IEA in renal pathology showed better fit in correlation with renal prognosis. Treatment with steroid/immunosuppressant showed no significant improvement regarding renal prognosis.

Funding

  • Government Support - Non-U.S.