Relationship between complement and macrophage markers with kidney survival in patients with diabetic nephropathy.

IF 3.1 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Acta Diabetologica Pub Date : 2025-05-08 DOI:10.1007/s00592-025-02521-3

Ozcan Uzun, Cihan Heybeli, Fatma Sema Anar Kutlu, Manolya Celebioglu Pekiner, Filiz Yıldırım, Caner Cavdar, Sulen Sarioglu

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引用次数: 0

Abstract

Background: Diabetic nephropathy (DN) is the leading cause of end-stage kidney disease (ESKD) worldwide. Macrophages and the complement system have interrelated roles in DN. We aimed to determine associations between macrophage and complement markers with the progression of DN.

Methods: This retrospective cohort study included patients diagnosed with sole DN by kidney biopsy. Using immunohistochemistry, CD68⁺ and CD163⁺ cells and complement markers were counted in glomerular and tubulointerstitial areas. The primary outcome was evolution to ESKD and/or doubling serum creatinine (SCr).

Results: Forty-six patients were included. The median SCr at baseline was 2.7 (1.41-3.1) mg/dL. During the median follow-up of 32 months (range 6-54), 50% of patients reached the primary outcome. Most of the clinical and histological findings were comparable between progressors and non-progressors, while progressors had a higher median number of glomerular CD68+ cells and a higher percentage of glomerulosclerosis. After adjustments for age, sex, and SCr, the median glomerular CD68+ cell number was the sole independent predictor of progression. Glomerular C4d was associated with nephrotic-range proteinuria but not with the progression of kidney failure.

Conclusions: Glomerular CD68+ cell count may serve as a promising predictor of kidney disease progression among patients with DN. Glomerular C4d was associated with nephrotic-range proteinuria but not with the progression of kidney failure.

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补体和巨噬细胞标志物与糖尿病肾病患者肾脏生存的关系。

背景：糖尿病肾病（DN）是世界范围内终末期肾病（ESKD）的主要原因。巨噬细胞和补体系统在DN中具有相互关联的作用。我们的目的是确定巨噬细胞和补体标志物与DN进展之间的关系。方法：本回顾性队列研究纳入了经肾活检诊断为单纯性DN的患者。应用免疫组化技术，对肾小球和小管间质区域的CD68+和CD163+细胞及补体标志物进行计数。主要结局是ESKD和/或血清肌酐（SCr）加倍。结果：纳入46例患者。基线时的中位SCr为2.7 (1.41-3.1)mg/dL。在中位随访32个月（6-54个月）期间，50%的患者达到了主要结局。大多数临床和组织学结果在进展者和非进展者之间具有可比性，而进展者肾小球CD68+细胞的中位数更高，肾小球硬化的百分比更高。在调整了年龄、性别和SCr后，肾小球CD68+细胞中位数是唯一独立的进展预测因子。肾小球C4d与肾范围蛋白尿相关，但与肾衰竭的进展无关。结论：肾小球CD68+细胞计数可能是DN患者肾脏疾病进展的一个有希望的预测指标。肾小球C4d与肾范围蛋白尿相关，但与肾衰竭的进展无关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Diabetologica 医学-内分泌学与代谢

CiteScore

7.30

自引率

2.60%

发文量

180

审稿时长

2 months

期刊介绍： Acta Diabetologica is a journal that publishes reports of experimental and clinical research on diabetes mellitus and related metabolic diseases. Original contributions on biochemical, physiological, pathophysiological and clinical aspects of research on diabetes and metabolic diseases are welcome. Reports are published in the form of original articles, short communications and letters to the editor. Invited reviews and editorials are also published. A Methodology forum, which publishes contributions on methodological aspects of diabetes in vivo and in vitro, is also available. The Editor-in-chief will be pleased to consider articles describing new techniques (e.g., new transplantation methods, metabolic models), of innovative importance in the field of diabetes/metabolism. Finally, workshop reports are also welcome in Acta Diabetologica.