PMID- 29610978
OWN - NLM
STAT- MEDLINE
DCOM- 20180727
LR  - 20181202
IS  - 1432-5233 (Electronic)
IS  - 0940-5429 (Linking)
VI  - 55
IP  - 7
DP  - 2018 Jul
TI  - The relationship between the thickness of glomerular basement membrane and renal 
      outcomes in patients with diabetic nephropathy.
PG  - 669-679
LID - 10.1007/s00592-018-1128-9 [doi]
AB  - AIMS: Glomerular basement membrane (GBM) thickening is considered as one of the 
      earliest detectable pathological features of diabetic nephropathy (DN). However, 
      whether the thickness of GBM will impact the prognosis of DN remains largely 
      unknown. Our aim was to explore the relationship between thickness of GBM and DN 
      progression in patients with type 2 diabetes mellitus (T2DM). METHODS: A total of 
      118 patients with T2DM and biopsy-proven DN who received follow-up for at least 
      1 year were recruited. The patients were divided into two groups according to the 
      median (787 nm) of the GBM thickness: Group 1: GBM thickness < 787 nm (n = 59), 
      and Group 2: GBM thickness >/= 787 nm (n = 59). The GBM width was estimated by the 
      direct GBM measurements as recently modified by Haas. Renal outcomes were defined 
      by progression to ESRD and/or doubling of serum creatinine (D-Cr). The influence 
      of GBM thickness on renal outcomes was assessed using Cox regression. RESULTS: 
      Compared with the Group 1, patients in Group 2 had more serious renal 
      insufficiency and glomerular lesions. During the follow-up, ESRD occurred in 
      39.8% of patients, and 8.5% of patients progressed to D-Cr. The univariate 
      analysis indicated the greater width of GBM the higher risk of renal outcomes in 
      T2DM patients with DN (HR [95% CI] = 2.180 [1.246-3.814], p = 0.006). However, 
      the multivariate COX analysis demonstrated that the GBM thickness was not an 
      independent risk factor for progression to ESRD or D-Cr (HR [95% CI] = 0.825 
      [0.404-1.685], p = 0.597) when adjusting for important clinical variables and 
      pathological findings. CONCLUSIONS: In conclusion, the DN patients with greater 
      width of GBM had relatively poorer renal prognosis, although it did not emerge as 
      an independent indicator of disease progression.
FAU - Zhang, Junlin
AU  - Zhang J
AD  - Division of Nephrology, West China Hospital of Sichuan University, No. 37, Guoxue 
      Alley, Chengdu, 610041, Sichuan Province, China.
FAU - Wang, Yiting
AU  - Wang Y
AD  - Division of Nephrology, West China Hospital of Sichuan University, No. 37, Guoxue 
      Alley, Chengdu, 610041, Sichuan Province, China.
FAU - Gurung, Pramesh
AU  - Gurung P
AD  - Division of Nephrology, West China Hospital of Sichuan University, No. 37, Guoxue 
      Alley, Chengdu, 610041, Sichuan Province, China.
FAU - Wang, Tingli
AU  - Wang T
AD  - Division of Nephrology, West China Hospital of Sichuan University, No. 37, Guoxue 
      Alley, Chengdu, 610041, Sichuan Province, China.
FAU - Li, Li
AU  - Li L
AD  - Division of Nephrology, West China Hospital of Sichuan University, No. 37, Guoxue 
      Alley, Chengdu, 610041, Sichuan Province, China.
FAU - Zhang, Rui
AU  - Zhang R
AD  - Division of Nephrology, West China Hospital of Sichuan University, No. 37, Guoxue 
      Alley, Chengdu, 610041, Sichuan Province, China.
FAU - Li, Hanyu
AU  - Li H
AD  - Division of Nephrology, West China Hospital of Sichuan University, No. 37, Guoxue 
      Alley, Chengdu, 610041, Sichuan Province, China.
FAU - Guo, Ruikun
AU  - Guo R
AD  - Division of Nephrology, West China Hospital of Sichuan University, No. 37, Guoxue 
      Alley, Chengdu, 610041, Sichuan Province, China.
FAU - Han, Qianqian
AU  - Han Q
AD  - Division of Nephrology, West China Hospital of Sichuan University, No. 37, Guoxue 
      Alley, Chengdu, 610041, Sichuan Province, China.
FAU - Zhang, Jie
AU  - Zhang J
AD  - Key Laboratory of Transplant Engineering and Immunology, Ministry of Health, 
      Regenerative Medicine Research Center, Chengdu, 610041, China.
FAU - Lei, Song
AU  - Lei S
AD  - Division of Pathology, West China Hospital of Sichuan University, Chengdu, 
      610041, China.
FAU - Liu, Fang
AU  - Liu F
AD  - Division of Nephrology, West China Hospital of Sichuan University, No. 37, Guoxue 
      Alley, Chengdu, 610041, Sichuan Province, China. liufangfh@163.com.
LA  - eng
GR  - 81670662/the National Natural Science Foundation of China/
GR  - 2016YFC1305502/National Research and Development Program/
PT  - Journal Article
DEP - 20180402
PL  - Germany
TA  - Acta Diabetol
JT  - Acta diabetologica
JID - 9200299
SB  - IM
MH  - Adult
MH  - Aged
MH  - Biopsy
MH  - Diabetes Mellitus, Type 2/complications/diagnosis/*pathology
MH  - Diabetic Nephropathies/*diagnosis/*pathology
MH  - Disease Progression
MH  - Female
MH  - Follow-Up Studies
MH  - Glomerular Basement Membrane/*pathology
MH  - Humans
MH  - Kidney/*pathology/physiopathology
MH  - Kidney Function Tests
MH  - Male
MH  - Middle Aged
MH  - Organ Size
MH  - Prognosis
MH  - Risk Factors
OTO - NOTNLM
OT  - Diabetic nephropathy
OT  - GBM thickness
OT  - Renal outcome
OT  - Renal pathology
EDAT- 2018/04/04 06:00
MHDA- 2018/07/28 06:00
CRDT- 2018/04/04 06:00
PHST- 2018/01/07 00:00 [received]
PHST- 2018/03/07 00:00 [accepted]
PHST- 2018/04/04 06:00 [pubmed]
PHST- 2018/07/28 06:00 [medline]
PHST- 2018/04/04 06:00 [entrez]
AID - 10.1007/s00592-018-1128-9 [pii]
AID - 10.1007/s00592-018-1128-9 [doi]
PST - ppublish
SO  - Acta Diabetol. 2018 Jul;55(7):669-679. doi: 10.1007/s00592-018-1128-9. Epub 2018 
      Apr 2.