However, renal biopsies have not revealed adequate information for predicting prognosis. Thus, this retrospective study was conducted of diabetic nephropathy to obtain prognostic information from histopathologic findings. Methods: The subjects were 28 diabetic nephropathy patients confirmed by renal biopsy who were seen between August 2007 and December 2012. Histopathological and clinical findings with renal outcomes were studied. The histopathological scores were determined according to Tervaert et al.: glomerular lesions (score 0–20)
were based on degree of mesangial expansion, GBM thickness, exudative lesion, nodular sclerosis, mesangiolysis, polar vasculosis, global sclerosis, segmental sclerosis, ischemic selleck screening library sclerosis, and hypertrophy; interstitial and tubular lesions (score 0–6) were based on degree of interstitial fibrosis, tubular atrophy, and interstitial inflammation; and vascular lesions (score 0–5) were based on degree of arteriolar hyalinosis and arteriosclerosis. Renal dysfunction was defined as doubling of serum creatinine
concentration, chronic hemodialysis initiation or renal transplantation. Results: Renal survival rates contrasting the low and high score groups in each of the three types of lesions were studied by Kaplan-Meier analysis. The mean survival periods of the low and high score groups for the glomerular H 89 (p = 0.24) and vascular (p = 0.22) lesions were not different. However, renal survival rates of 19 and 8 months for the low and high score groups (p = 0.010) respectively, in the interstitial and tubular lesions were significant. Conclusion: Interstitial and tubular lesions were a significant predictor for renal prognosis in diabetic nephropathy. Inasmuch as the histopathology of the glomerulus is known to provide important information of renal disease, our study indicates that significant prognostic information
may be associated with interstitial and tubular changes. MENG XIANJIE1, SHEN SHANMEI2, WAN YIGANG2, LUO XUNYANG2, ZHANG LE2, CHEN HAOLI1, SHI XIMIAO1, HUANG YANRU1, MAO ZHIMIN1 1Department of Graduate School, Nanjing University of Chinese Medicine; 2Nanjing Ribonucleotide reductase Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School Introduction: Diabetic nephropathy (DN), as a common health problem worldwide, is a dominant cause of end-stage renal disease (ESRD). Therefore, noninvasive detections and dynamic managements in clinic are of major importance of preventing progression from DN to ESRD. The early diagnosis of DN has focused on measurement of urinary albumin (UAlb) excretion rate, but UAlb is actually not overall and sensitive marker for DN patients with inchoate and latent injuries in glomeruli and renal tubules.