Kidney Week

Abstract: PO0961

Assessment of Histopathological Prognosticators in Diabetic Nephropathy: Single-Center Experience

Session Information

• Diabetic Kidney Disease: Clinical - 1
  October 22, 2020 | Location: On-Demand
  Abstract Time: 10:00 AM - 12:00 PM

Category: Diabetic Kidney Disease

• 602 Diabetic Kidney Disease: Clinical

Authors

• Khalaf, Ahmad Mansoor, Hamad Medical Corporation, Doha, Ad Dawhah, Qatar

Ahmad Mansoor Khalaf,

• Nauman, Awais, Hamad Medical Corporation, Doha, Ad Dawhah, Qatar

Awais Nauman,

• Alkadi, Mohamad M., Hamad Medical Corporation, Doha, Ad Dawhah, Qatar

Mohamad M. Alkadi,

• Abdelaziz, Adel Ashour, Hamad Medical Corporation, Doha, Ad Dawhah, Qatar

Adel Ashour Abdelaziz,

• Hamdi, Ahmed Farouk, Hamad Medical Corporation, Doha, Ad Dawhah, Qatar

Ahmed Farouk Hamdi,

• Asim, Muhammad, Hamad Medical Corporation, Doha, Ad Dawhah, Qatar

Muhammad Asim,

• Fituri, Omar, Hamad Medical Corporation, Doha, Ad Dawhah, Qatar

Omar Fituri,

• Al-Malki, Hassan A., Hamad Medical Corporation, Doha, Ad Dawhah, Qatar

Hassan A. Al-Malki,

• Akhtar, Mohammed, Hamad Medical Corporation, Doha, Ad Dawhah, Qatar

Mohammed Akhtar,

• Abuhelaiqa, Essa, Hamad Medical Corporation, Doha, Ad Dawhah, Qatar

Essa Abuhelaiqa,

Background

Diabetic nephropathy (DN) is the leading cause of end stage kidney disease worldwide. Identification of clinical, laboratory and histopathological predictors of kidney failure in DN may improve outcomes.

Methods

We identified 45 kidney biopsies between 2017 to 2018 that were diagnosed with DN. Clinical, laboratory and histopathological variables were analyzed to prognosticate 1-year kidney failure.

Results

Sixteen of 45 patients with DN had kidney failure within 12 months of kidney biopsy while 29 patients did not. All patients who developed kidney failure had diabetic retinopathy as shown in table 1. Laboratory findings such a serum creatinine (597umol/L vs. 205umol/L, P<0.0001) and presence of hematuria (88% vs. 45%, P=0.01) prognosticated kidney outcome, while neither proteinuria or Hemoglobin A1C did. IFTA score ( 2.4 vs. 1.8, P=0.02) and global glomerular sclerosis (52% vs. 32%, P=0.002) were the only histological findings that prognosticate kidney failure. Patients who have a second kidney diagnosis in addition to DN such as IgA, FSGS and MN had favorable outcomes compared to DN and AIN or DN only [figure 1].

Conclusion

We identified serum creatinine, hematuria, IFTA and glomerular sclerosis as prognosticators of kidney failure at 1-year following DN diagnosis. Identification of patients at risk of kidney failure help individualize therapy and hence improve kidney outcomes.