Intraglomerular dysfunction may predict kidney failure in type 2 diabetes patients: Study

Written By : Medha Baranwal |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2021-07-20T09:00:22+05:30 | Updated On 20 July 2021 11:07 AM IST

USA: Intraglomerular dysfunction can predict kidney failure in type 2 diabetes (T2D) patients, suggests a recent study in Diabetes, the journal of the American Diabetes Association.

The study found intraglomerular hemodynamic parameters to be strongly associated with incident end-stage kidney disease (ESKD) and correlated with structural lesions of diabetic kidney disease (DKD).

In people with type 2 diabetes, none of the longitudinal data has linked intraglomerular hemodynamic dysfunction with ESKD. Afferent (RA) and efferent (RE) arteriolar tone and intraglomerular pressure (PGLO) are estimated from glomerular filtration rate (GFR), renal plasma flow (RPF), blood pressure, hematocrit, and plasma oncotic pressure and are not directly measurable.

Against the above background, c, NIDDK, Phoenix, AZ USA, and colleagues aimed to examine the association of the RA/RE ratio and PGLO with ESKD incidence in 237 Pima Indian persons with T2D who underwent serial measures of GFR (iothalamate) and RPF (p-aminohippurate). The researchers also examined their association with kidney structural lesions in a subset of 111 participants.

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Upon analysis, the researchers found the following:

During a median follow-up of 17.5 years, out of 237 participants (mean age 42 years, diabetes duration 11 years, GFR 153 ml/min, median ACR 36 mg/g), 69 progressed to ESKD.
In latent class analysis, distinct trajectories characterized by increasing R_A/R_E ratio (HR: 4.60) or elevated P_GLO followed by a rapid decline (HR: 2.96) strongly predicted incident ESKD. P_GLO (R²=21%,) and R_A/R_E (R²=15%,) also correlated with mesangial fractional volume, a structural predictor of DKD progression.

Our findings showed that intraglomerular hemodynamic parameters are associated strongly with incident ESKD and correlated with structural lesions of DKD, concluded the authors.

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Reference:

The study titled, "Intraglomerular dysfunction predicts kidney failure in type 2 diabetes," is published in the ADA journal Diabetes.

DOI: https://diabetes.diabetesjournals.org/content/early/2021/07/13/db21-0154

type 2 diabetesintraglomerular dysfunctionkidney failurejournal Diabetes

Source : journal Diabetes

Medha Baranwal

MSc. Biotechnology

Medha Baranwal joined Medical Dialogues as an Editor in 2018 for Speciality Medical Dialogues. She covers several medical specialties including Cardiac Sciences, Dentistry, Diabetes and Endo, Diagnostics, ENT, Gastroenterology, Neurosciences, and Radiology. She has completed her Bachelors in Biomedical Sciences from DU and then pursued Masters in Biotechnology from Amity University. She has a working experience of 5 years in the field of medical research writing, scientific writing, content writing, and content management. She can be contacted at editorial@medicaldialogues.in. Contact no. 011-43720751

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751