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Kidney Week

Abstract: SA-PO463

Progression to ESKD in Type 1 Diabetes by Histological Findings

Session Information

Category: Diabetic Kidney Disease

  • 702 Diabetic Kidney Disease: Clinical

Authors

  • Haar, Karina, Department of Medicine, Zealand University Hospital, Roskilde, Denmark
  • Persson, Frederik, Steno Diabetes Center Copenhagen, Herlev, Capital Region, Denmark
  • Bressendorff, Iain Oshoj, Department of Nephrology, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark
  • Hansen, Ditte, Department of Nephrology, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark
  • Møller, Marie, Department of Nephrology, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark
  • Rossing, Peter, Steno Diabetes Center Copenhagen, Herlev, Denmark
  • Borg, Rikke, Department of Medicine, Zealand University Hospital, Roskilde, Denmark

Group or Team Name

  • PRIMETIME.
Background

Kidney disease in diabetes is a heterogeneous disease. To improve personalized medicine in people with diabetes, it is crucial to identify people at risk of progressing to end-stage kidney disease (ESKD). This study aims to investigate if progression to ESKD differs by biopsy-proven type of kidney disease in people with type 1 diabetes (T1D).

Methods

In this retrospective registry study, we included all Danish adults with T1D from 1996-2020 who had a kidney biopsy performed. The included individuals had diabetic nephropathy (DN)(n=132), non-diabetic nephropathy (NDN)(n=73), mixed disease (n=39), normal histopathology (n=5), or could not be classified (NC)(n=78). Demography, clinical presentation, laboratory values, and prevalence of comorbidity were described by compiling unique national registry data. Within the type of kidney disease, we analyzed progression to ESKD.

Results

The DN group consisted of 71% men with systolic blood pressure (SBP) of 146±21 mmHg and a body mass index (BMI) of 25.1±5.5 kg/m2. In NDN and mixed disease groups 66% and 59%, respectively, were men. In NDN, mean SBP was 137±18 mmHg and they had a BMI of 24.6±3.5 kg/m2. Those with mixed disease had a mean SBP of 135±21 mmHg and a BMI of 24.7±3.7 kg/m2. Median and interquartile range [IQR] estimated glomerular filtration rate (ml/min/1.73m2) and urine albumin-creatinine ratio (mg/g) were 37 [22.6, 54.1] and 2670 [935.4, 4390.7] in DN, 41 [14.0, 85.0] and 857 [304.5, 3860.5] in NDN, 27 [16.4, 71.8] and 1240 [435.0, 3472.0] in mixed disease, 29 [20.6, 36.5] and 201 [118.0, 984.7] in normal histology, and 35 [12.5, 62.5] and 436 [40.0, 2281.0] in NC, respectively. During a median [IQR] follow-up time of 22.6 [14.5, 30.4] years, 61% with DN advanced to ESKD, compared to 52% with NDN, 59% with mixed disease, and 46% with NC. There were no significant differences between groups. Likewise, there was no significant difference in median [IQR] time to progression of ESKD; 17.4 [12.0, 21.9] years in DN, 14.9 [9.1, 23.0] years in NDN, 19.6 [17.1, 27.4] years in mixed disease, 24.1 [19.3, 26.0] years in normal histopathology, and 18.5 [11.3, 24.8] years in NC.

Conclusion

In people with T1D, retrospective analysis of registry data did not find a significant difference in risk of progression to ESKD or time to ESKD within biopsy-proven type of kidney disease.

Funding

  • Private Foundation Support