Kidney Week

Abstract: SA-PO0952

Synergistic Effect of Obesity on Hypertensive Renal Arteriosclerosis in Individuals Without CKD: A Zero-Hour Biopsy-Based Cohort Study

Session Information

• Pathology: Updates and Insights
  November 08, 2025 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Pathology and Lab Medicine

• 1800 Pathology and Lab Medicine

Authors

• Okamoto, Hirofumi, Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

Hirofumi Okamoto

• Matsukuma, Yuta, Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

Yuta Matsukuma, MD

• Ataka, Eri, Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

Eri Ataka, MD

• Ueki, Kenji, Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

Kenji Ueki, MD, PhD

• Tsuchimoto, Akihiro, Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

Akihiro Tsuchimoto, MD, PhD

• Masutani, Kosuke, Division of Nephrology and Rheumatology, Department of Internal Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan

Kosuke Masutani, MD, PhD

• Noguchi, Hirsoshi, Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

Hirsoshi Noguchi, PhD

• Kaku, Keizo, Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

Keizo Kaku, PhD

• Ago, Tetsuro, Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

Tetsuro Ago, MD, PhD

• Nakano, Toshiaki, Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

Toshiaki Nakano, MD, PhD

Group or Team Name

• Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University.

Background

Nephrosclerosis from aging and hypertension including prehypertensive blood pressure (BP) levels have been reported as a leading cause of end-stage kidney disease. However, their effects on early renal pathological changes remain unclear. We examined the association of aging and BP levels with renal pathological changes.

Methods

We evaluated 520 living kidney donors at Kyushu University Hospital during January 2008 and December 2018 with a 0-hour biopsy. Patients were divided into three groups, [normal BP levels (<130/80 mmHg), Stage I hypertension (130–139/80–89 mmHg), Stage II hypertension (>= 140/90 mmHg and/or with anti-hypertensive drugs] and into four groups by age levels (<40, 40-49, 50-59, and 60-79 years). The outcomes were renal pathological changes, arteriolar hyalinization (AH), intimal thickening of small-medium arteries (IT), global glomerular sclerosis (GS).

Results

AH, IT, and GS increased with higher BP levels and aging: the multivariable-adjusted odds ratio (OR) (95% confidence interval) for AH were 1.25 (0.74-2.12) in Stage I hypertension and 1.63 (1.02-2.61) in Stage II hypertension compared to normal BP level. IT and GS increased not only in the elderly but also in the middle age, 50-59 years (IT: OR 3.56 [1.27-9.98] for 50-59 group and OR 5.61 [1.81-17.41] for 60-79 group, GS: OR 3.09 [1.00- 9.53] for 50-59 group and OR 7.87 [2.34-26.43] for 60-79 group versus <40 group). In obesity patients, both Stage I and Stage II hypertension were significantly risk factors for AH (the multivariable-adjusted OR 3.72 [1.06-13.1] for Stage I hypertension and OR 4.05 [1.38-11.85] for Stage II hypertension), and there was a significant interaction (p = 0.03).

Conclusion

IT and GS increased from middle age even in a healthy population. Furthermore, obesity modified the association between BP levels and AH.

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.2025mct9gzat