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Kidney Week

Abstract: PO0778

Histological Diabetic Nephropathy in Autopsied Diabetic Cases with Normoalbuminuria from a Japanese Community-Based Study: The Hisayama Study

Session Information

Category: Diabetic Kidney Disease

  • 602 Diabetic Kidney Disease: Clinical

Authors

  • Sasaki, Takaya, Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
  • Nakagawa, Kaneyasu, Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
  • Hata, Jun, Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
  • Hirakawa, Yoichiro, Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
  • Shibata, Mao, Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
  • Nakano, Toshiaki, Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
  • Tsuboi, Nobuo, Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
  • Oda, Yoshinao, Department of Anatomic Pathology, Pathological Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
  • Kitazono, Takanari, Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
  • Yokoo, Takashi, Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
  • Ninomiya, Toshiharu, Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
Background

Albuminuria is a clinical indicator of diabetic nephropathy (DN). However, it is controversial whether pathological DN lesions are present in diabetic individuals with normal albuminuria. We investigated the association between albuminuria levels and the frequency of DN lesions in autopsied diabetic cases from a Japanese community.

Methods

Autopsied specimens obtained from deceased people in the town of Hisayama from 2002 to 2017 were used in the present study. During this period, 131 deceased individuals with diabetes underwent autopsy examinations. A total of 106 autopsied cases with diabetes mellitus (mean age 76 years, 43.4% male) who died within 6 years since the last health examination were included in the study. Urinary albumin-creatinine ratio (UACR) levels were divided into three groups: <30.0, 30.0–299.9, and ≥300.0 mg/g. The kidney specimens were evaluated with light microscopy, and were categorized into class 0–I, IIa, IIb, and III glomerular DN lesions according to the Renal Pathology Society’s criteria. A Cochrane-Armitage test was used to examine the association between the UACR levels and the presence of class IIa or higher glomerular DN lesions.

Results

In the overall cases, the frequency of class IIa or higher glomerular DN lesions was 63.2% (IIa, 36.8%; IIb, 3.8%; and III, 22.6%).Its frequencies increased significantly with higher UACR levels (P for trend = 0.02, Figure). Even in individuals with UACR of <30 mg/g, the frequency of class IIa or higher glomerular DN lesions was 51.2%.

Conclusion

The present study showed a positive association of the UACR levels with the presence of class IIa or higher glomerular DN lesions, which were also frequently found even in the normoalbuminuric range, among autopsied diabetic cases from a Japanese community.

Figure.