Abstract: FR-PO0339
Clinical and Pathological Characteristics of Diabetic Nephropathy with or Without Diabetic Retinopathy
Session Information
- Diabetic Kidney Disease: Progression, Predictive Tools, Therapeutics, and Outcomes
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Diabetic Kidney Disease
- 702 Diabetic Kidney Disease: Clinical
Authors
- Ikenouchi, Ayako, Nihon Ika Daigaku Fuzoku Byoin, Bunkyo, Tokyo, Japan
- Morita, Megumi, Nihon Ika Daigaku Fuzoku Byoin, Bunkyo, Tokyo, Japan
- Yasuda, Fumihiko, Nihon Ika Daigaku Fuzoku Byoin, Bunkyo, Tokyo, Japan
- Mii, Akiko, Nihon Ika Daigaku Fuzoku Byoin, Bunkyo, Tokyo, Japan
- Shimizu, Akira, Nihon Ika Daigaku, Bunkyo, Tokyo, Japan
Background
Microangiopathies of diabetic nephropathy (DN) are known to include structural disintegrative disorders that form diffuse and nodular lesions of DN, as well as functional disorders that result in an inability to retain plasma proteins in the vasculature, forming glomerular hyaline cap, capsular drop and hyalinosis of afferent and efferent arterioles.
Methods
We searched for cases of diabetes in which both fundus examination and renal biopsy had been performed. Of these, we selected 29 cases of DN, with or without diabetic retinopathy, and excluded 11 cases of DN complicated by other glomerular diseases. We examined the clinicopathological characteristics of DN in cases with or without diabetic retinopathy.
Results
Clinically, no significant differences were observed in renal function, proteinuria or HbA1c levels according to whether patients had diabetic retinopathy or not. However, cases with retinopathy were significantly younger (age 53±14 vs 67±7 years old) and had a longer history of diabetes (4.2±6.1 vs 12±12 years) than cases without retinopathy.
Renal biopsy findings in patients with retinopathy showed that most were classified as having DN class III (55% of cases) or class IV (35% of cases), according to the pathological classification (RPS2010). The degree of hyalinosis in glomeruli and small arterioles was also high: 24±14% of arterial hyalinosis areas in cases of simple retinopathy and 31±18% in cases of proliferative retinopathy. Most cases in the retinopathy-absent group were classified as class II DN (56%), but there were also cases of class III (33%) or class IV (11%),which presented with numerous nodular lesions. The degree of hyalinosis lesions was mild (7 ± 7% of arterial hyalinosis areas). Patients in the retinopathy-present group had significantly larger areas of hyalinosis in glomeruli and small arterioles than patients in the retinopathy-absent group.
Conclusion
The development of DN involves structural disintegrative as well as functional disorder microangiopathy. In diabetic patients with retinopathy, the microangiopathy of DN often progresses to both structural disintegrative and functional disorder microangiopathy. However, cases without retinopathy showed less progression of functional disorder microangiopathy, although structural disintegrative microangiopathy progressed in DN.
Funding
- Government Support – Non-U.S.