Abstract: SA-PO539
Impact on Kidney Function with Focal and Segmental Glomerulosclerosis (Tip) in Patients with Diabetic Nephropathy
Session Information
- Diabetic Kidney Disease: Pathology, Epidemiology
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Diabetic Kidney Disease
- 602 Diabetic Kidney Disease: Clinical
Authors
- Rosero, Ivan, Hospital General de Mexico, Mexico City, Mexico
- Argudo sanchez, Diego Fernando, Hospital General de Mexico, Mexico City, Mexico
- Soto, Virgilia, INC Ignacio Chavez, Mexico City, Mexico
- Valdez-Ortiz, Rafael, Hospital General de Mexico, Mexico City, Mexico
- Matias, Adrian Rodriguez, Hospital General de Mexico, Mexico City, Mexico
Background
Type 2 Diabetes Mellitus is the first cause of end stage kidney disease (ESKD). Focal and Segmental Glomeruloesclerosis (FSG) is the most common glomerulopathy in western world. Tip variant is the most common glomerulopathy associated with Diabetic Nephropathy (DN). By now, only mathematic and experimental models tried to explain the association between DN and FSG (tip) without including the clinical impact and the prognosis of these patients. This study is the first in Mexico which evaluates this combination and the clinical impact.
Methods
Retrospective cohort with patients over 18 years with renal biopsy who at that moment, didn't had ESKD. We did descriptive and analytic statistics and a survival analysis with Kaplan Meier. We considered as primary outcome, the need of dialysis, lowering glomerular filtration rate (GFR) >50% of basal value and/or doubling the basal serum creatinine.
Results
41 patients included, 64% (26) male, 73% (30) had hypertension at the moment of the biopsy, 83% (34) had nephrotic syndrome, the chronic changes score (CCS) were moderate or severe in >90% of patients. The age was 51±13, follow up of 18±12 months, the initial proteinuria was 8.8±4.3 gr/24h in the group without FSG and 8.3±5.7 gr/24h in the other group. The proteinuria at 6 months after the biopsy was different between groups (p= 0.03). The group without FSG had worse GFR, but with no difference in the analysis of the primary outcome, (Figure 1)
Conclusion
There was no difference between groups in the primary outcome, but we observe some clinical differences. The CCS did evaluate better the outcomes than the histologic changes in both groups. Maybe further studies with more patients, could find a difference in the impact of FSG on kidney function proposed in our study.