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Kidney Week

Abstract: PO0780

Prevalence and Risk Factors Associated with Diabetic Nephropathy in Patients with Diabetes Undergoing Nephrectomy

Session Information

Category: Diabetic Kidney Disease

  • 602 Diabetic Kidney Disease: Clinical

Authors

  • Aponte Becerra, Laura, University of Miami School of Medicine, Miami, Florida, United States
  • Salcedo Betancourt, Juan David, University of Miami School of Medicine, Miami, Florida, United States
  • Fornoni, Alessia, University of Miami Katz Family Division of Nephrology and Hypertension, Miami, Florida, United States
  • Iakymenko, Oleksii, University of Miami School of Medicine, Miami, Florida, United States
  • Contreras, Gabriel, University of Miami Katz Family Division of Nephrology and Hypertension, Miami, Florida, United States
  • Marin, Sara, University of Miami School of Medicine, Miami, Florida, United States
  • Rodriguez, Juanly N., University of Miami Katz Family Division of Nephrology and Hypertension, Miami, Florida, United States
  • Mohsin, Noreen, University of Miami School of Medicine, Miami, Florida, United States
  • Garcia Valencia, Oscar Alejandro, University of Miami School of Medicine, Miami, Florida, United States
  • Santana Rodriguez, Abraham, University of Miami Katz Family Division of Nephrology and Hypertension, Miami, Florida, United States
  • Barisoni, Laura, Duke University, Durham, North Carolina, United States
  • Thomas, David B., IYM Health Financial services, PLLC, Charlotte, North Carolina, United States
  • Munoz Mendoza, Jair, University of Miami Katz Family Division of Nephrology and Hypertension, Miami, Florida, United States
Background

Diabetic kidney disease (DKD) affects about 40% of patients with diabetes and is the most common cause of end-stage renal disease in the US. The prevalence of morphologic features of DKD, known as diabetic nephropathy (DN), is likely underestimated since kidney biopsies are performed when other diseases are clinically suspected. The availability of non-neoplastic kidney tissue from nephrectomies offers us the opportunity to evaluate the prevalence and risk factors associated with morphologic evidence of DKD.

Methods

A total of 198 nephrectomies of diabetic patients, where the status of the non-neoplastic kidney tissue was reported, were included. Clinical, demographic, and histological data were collected retrospectively. Logistic regression models were used to examine the association between clinical and demographic characteristics as primary exposure and morphologic evidence of DKD as the dependent variable.

Results

The mean age across all diabetic patients undergoing nephrectomy was 64±11 years, 59% were male, 9% African-American (AA), and 39% Hispanics. Clinical DKD was found in 47% of patients, 60% had hypertension, 66% had a GFR ≥ 60mL/min/1.73m2 and 62% had no proteinuria. Morphologic features of DKD were observed in 56 (28%) patients. In multivariable-adjusted logistic regression analyses, the presence of morphologic features of DKD was significantly associated with older age (odds ratio [OR] per 10-year increase, 1.64 [95% confidence interval (CI), 1.08-2.48]), proteinuria (OR, 2.27 [95% CI, 0.99-5.17]), and neuropathy (OR, 4.92 [95% CI, 1.76-13.75]). The presence of morphologic features of DKD was associated with retinopathy only in univariate analysis (OR, 8.47 [95% CI, 1.65-43.47]). No association ((p>0.05) with AA race, hypertension, clinical DKD, and eGFR was noted.

Conclusion

Morphologic features of DKD are highly prevalent in patients undergoing nephrectomy. Older age, proteinuria, and neuropathy were independently associated with significantly greater odds of morphologic evidence of DKD. Future studies should evaluate the prevalence of non-diabetic renal disease in patients with diabetes undergoing nephrectomy.