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논문분류	춘계학술대회 초록집
제목	Kidney biopsy can help to predict renal outcomes of patients with type 2 diabetes
저자	Taehoon Oh
출판정보	2024; 2024(1):
키워드
초록	Objectives: In patients with type 2 diabetes mellitus (T2DM), diabetic kidney disease (DKD) is diagnosed based on clinical features. A kidney biopsy is used only in selected cases. This study aimed to reconsider the role of a biopsy in predicting renal outcomes. Methods: Clinical and laboratory parameters and renal biopsy results were obtained from 237 patients with type 2 diabetes who underwent renal biopsies at Soonchunhyang University Cheonan Hospital between January 2000 and March 2020 and were analyzed. Results: Of 237 diabetic patients, 29.1% had DKD only, 61.6% had non-diabetic kidney disease (NDKD), and 9.3% had DKD with coexisting NDKD (DKD/NDKD). Of the patients with DKD alone, 43.5% progressed to end-stage kidney disease (ESKD), while 15.8% NDKD patients and 36.4% DKD/NDKD patients progressed to ESKD (p < 0.01). eGFR and 24-hour urinary protein values were not correlated with progression to ESKD in the DKD, NDKD, and DKD/NDKD groups. In the DKD-alone group, pathologic features like ≥ 50% global sclerosis (p < 0.01), tubular atrophy (p < 0.01), interstitial fibrosis (p < 0.01), interstitial inflammation (p < 0.01), and the presence of hyalinosis (p = 0.03) were related to worse renal outcomes. The Cox regression model showed a higher risk of progression to ESKD in the DKD/NDKD group (hazard ratio (HR) = 2.73, p = 0.03), ≥ 50% global sclerosis (HR = 3.88, p < 0.01), and the degree of mesangial expansion (moderate, HR = 2.45, p = 0.05; severe, HR = 6.22, p < 0.01). Conclusions: In patients with T2DM, a kidney biopsy can help in identifying patients with NDKD for appropriate treatment, and it has predictive value.
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