Abstract: TH-PO553
Factors Associated With Excessive Glomerular Hypertrophy in Patients With CKD: Renal Biopsy-Based Study
Session Information
- Pathology and Lab Medicine
November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Pathology and Lab Medicine
- 1700 Pathology and Lab Medicine
Authors
- Zamami, Ryo, Ryukyu Daigaku, Nakagami-gun, Okinawa, Japan
- Kohagura, Kentaro, Ryukyu Daigaku, Nakagami-gun, Okinawa, Japan
- Ohya, Yusuke, Ryukyu Daigaku, Nakagami-gun, Okinawa, Japan
Background
Loss of nephrons leads to compensatory hypertrophy of the residual glomeruli, and glomerular hypertrophy beyond the compensatory range due to impaired renal autoregulation triggers progressive renal dysfunction. Various factors have been reported to as a cause of glomerular hypertrophy, but it is unclear which factors are most associated with excessive glomerular hypertrophy. In this study, we used renal biopsy specimens to determine which factors are most associated with excessive glomerular hypertrophy.
Methods
Subjects were 104 patients who underwent renal biopsy at the University of the Ryukyus Hospital from 2016 to 2017, excluding those with less than 5 glomeruli collected. Predicted maximum glomerular diameter was determined by simple regression analysis using the glomerular density and maximum glomerular diameter of each specimen, and the difference between the measured and predicted maximum glomerular diameter was defined as the glomerular hypertrophy index (GHI). Multiple regression analysis was used to determine the most relevant factors for the GHI using following factors associated with impaired renal autoregulation as variables: age, gender, systolic blood pressure, body mass index (BMI), creatinine clearance, serum uric acid level (SUA), HbA1c, protein intake, and use of renin-angiotensin-aldosterone system inhibitors. The fourth quartile of GHI was defined as the excessive glomerular hypertrophy group, and multiple logistic analysis was performed using the same variables.
Results
The median age of the subjects was 49 years, and the median eGFR was 67 ml/min/1.73 m2. In simple regression analysis, BMI, HbA1c, and SUA were significantly associated with GHI. In multiple regression analysis, BMI and HbA1c were significantly associated with GHI independently of other factors, with standardized partial regression coefficients of 0.325 and 0.249, respectively. In multiple logistic analysis, only BMI was associated with excessive glomerular hypertrophy.
Conclusion
BMI may lead to excessive glomerular hypertrophy in patients with chronic kidney disease.