Type 2 diabetic patients with diabetic retinopathy and concomitant microalbuminuria showed typical diabetic glomerulosclerosis and progressive renal dysfunction

To determine whether or not diabetic retinopathy (DR) in type 2 diabetic patients can predict the renal functional decline. We examined 32 normo-microalbuminuric type 2 diabetic patients by renal biopsy (23 men, age 49±10yrs) divided into two groups according to the presence (n=19) or absence (n=13)...

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Published in:Journal of diabetes and its complications 2016-08, Vol.30 (6), p.1111-1116
Main Authors: Moriya, Tatsumi, Matsubara, Madoka, Kishihara, Eriko, Yoshida, Yuki, Ouchi, Motoshi
Format: Article
Language:English
Subjects:
Adult
Albuminuria - physiopathology
Biopsy
Blood pressure
Diabetes
Diabetes Mellitus, Type 2 - physiopathology
Diabetic glomerulosclerosis
Diabetic Nephropathies - physiopathology
Diabetic nephropathy
Diabetic retinopathy
Diabetic Retinopathy - physiopathology
Female
Glomerular Filtration Rate
Histological heterogeneity
Hospitalization
Hospitals
Humans
Kidney Glomerulus - physiopathology
Laboratories
Male
Microalbuminuria
Middle Aged
Renal function
Urine
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Summary:To determine whether or not diabetic retinopathy (DR) in type 2 diabetic patients can predict the renal functional decline. We examined 32 normo-microalbuminuric type 2 diabetic patients by renal biopsy (23 men, age 49±10yrs) divided into two groups according to the presence (n=19) or absence (n=13) of DR. Electron microscopic morphometry including mesangial fractional volume [Vv(Mes/glom)] were performed and light microscopic tissues were categorized as: C1, normal/near normal renal structure; C2, typical diabetic glomerulopathy; C3, atypical injury patterns. Patients were followed up for 7.1±3.8years, and glomerular filtration rate (GFR) and urinary albumin excretion (UAE) measurements were taken annually. Vv(Mes/glom) was larger in DR+ than that in DR–. Vv(Mes/glom) positively correlated with the UAE if patients had DR. The patients with DR had a significant higher rate of C2 pattern compared to those in DR–. Among patients with DR and C2, GFR in microalbuminuria (n=7) decreased while GFR in normoalbuminuria (n=5) did not change during the observation. Type 2 diabetic patients with DR and C2 showed progressive renal dysfunction after they had microalbuminuria. DR and albuminuria should be considered to determine renal function decline in type 2 diabetic patients.
ISSN:1056-8727
1873-460X
DOI:10.1016/j.jdiacomp.2016.04.007