Renal arteriolar hyalinosis, not intimal thickening in large arteries, is associated with cardiovascular events in people with biopsy-proven diabetic nephropathy

• Project/Area Number: 18K15984
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 53040:Nephrology-related
• Research Institution: Nara Medical University
• Principal Investigator: SAMEJIMA KENICHI 奈良県立医科大学, 医学部, 講師 (00460858)
• Project Period (FY): 2018-04-01 – 2021-03-31
• Project Status: Completed (Fiscal Year 2020)
• Budget Amount: ¥4,030,000 (Direct Cost: ¥3,100,000、Indirect Cost: ¥930,000); Fiscal Year 2020: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000); Fiscal Year 2019: ¥520,000 (Direct Cost: ¥400,000、Indirect Cost: ¥120,000); Fiscal Year 2018: ¥2,730,000 (Direct Cost: ¥2,100,000、Indirect Cost: ¥630,000)
• Keywords: 糖尿病性腎症 / 透析 / 心血管イベント / 細小血管 / ヒアリノーシス / 血尿 / 腎予後 / 蛋白尿 / 糸球体病変 / 間質性病変 / 動脈硬化

Outline of Final Research Achievements

We analyzed 410 histopathological specimens of diabetic nephropathy, and found that mesangial proliferation and nodular lesions were associated with dialysis induction. We found that mesangial proliferation and nodular lesions were associated with the initiation of hemodialysis, and arteriolar hyalinosis was associated with cardiovascular events, but intimal thickening in large
arteries was not associated with renal prognosis or cardiovascular events. In addition, diabetic nephropathy patients with hematuria had a higher risk of dialysis than those without hematuria.

Academic Significance and Societal Importance of the Research Achievements

われわれは，糖尿病性腎症患者の中で，透析導入や心血管イベントを引き起こしやすい患者群として，糖尿病性腎症の病理学的特徴と細動脈のヒアリノーシスを発見した．また，血尿を合併していることが透析導入のリスク因子であることも報告した．このこととにより，糖尿病性腎症患者を腎生検することでそれらのハイリスク患者に対して，血糖や血圧管理のみならず，脂質管理や食事療法，運動療法をより厳格に行い，透析導入や心血管イベントの発症を抑制できる可能性がある．また，糖尿病性腎症患者で血尿を認める場合，透析導入のリスクが高いことを念頭に治療が可能となる．

Research Products

• [Journal Article] Renal arteriolar hyalinosis, not intimal thickening in large arteries, is associated with cardiovascular events in people with biopsy‐proven diabetic nephropathy (2020)
  • Author(s): Morimoto K.、Matsui M.、Samejima K.、Kanki T.、Nishimoto M.、Tanabe K.、Murashima M.、Eriguchi M.、Akai Y.、Iwano M.、Shiiki H.、Yamada H.、Kanauchi M.、Dohi K.、Tsuruya K.、Saito Y.
  • Journal Title: Diabetic Medicine Volume: 37 Issue: 12 Pages: 2143-2152
  • DOI: 10.1111/dme.14301
  • Peer Reviewed
• [Journal Article] Microscopic hematuria is a risk factor for end-stage kidney disease in patients with biopsy-proven diabetic nephropathy (2020)
  • Author(s): Okada S, Samejima KI, Matsui M, Morimoto K, Furuyama R, Tanabe K, Eriguchi M, Akai Y, Saito Y, Tsuruya K.
  • Journal Title: BMJ Open Diabetes Research Care . Volume: 8 Issue: 2 Pages: e001863-e001863
  • DOI: 10.1136/bmjdrc-2020-001863
  • Peer Reviewed
• [Presentation] Association of Renal Pathological Lesions and Renal Prognosis in Patients with Diabetic Nephropathy and Effect Modification by Proteinuria. (2020)
  • Author(s): Fukata F, Eriguchi M, Tasaki H, Furuyama R, Nishimoto M, Kosugi T, Tanabe K, Morimoto K, Matsui M, Samejima K, Tsuruya K.
  • Organizer: ASN Kidney Week 2020
• [Presentation] Microscopic Hematuria is a Risk Factor for End-Stage Kidney Disease in Patients with Biopsy-Proven Diabetic Nephropathy (2020)
  • Author(s): Furuyama R, Eriguchi M, Tasaki H, Fukata F, Nishimoto M, Kosugi T, Tanabe K, Morimoto K, Okada S, Matsui M, Samejima K, Tsuruya K
  • Organizer: ASN Kidney Week 2020
• [Presentation] 尿蛋白の少ない糖尿病性腎症における腎組織病変と腎予後の関連 (2020)
  • Author(s): 深田 文裕，鮫島謙一
  • Organizer: 第49回日本腎臓学会西部学術大会
• [Presentation] Synergistic Effects of Glomerular Lesion and Interstitial Lesion on Increased Proteinuria But Not on Renal Prognosis (2019)
  • Author(s): Eriguchi M
  • Organizer: Kidney Week 2019, The 52st Annual Meeting of the American Society of Nephrology
  • Int'l Joint Research