The role of Kimmelstiel-Wilson nodule in the kidney outcome in patients with diabetic kidney disease: A two-center retrospective cohort study. (August 2022)

• Record Type: Journal Article
• Authors: Zhou, Yue; Chang, Dong-yuan; Li, Jing; Shan, Ying; Huang, Xiao-yan; Zhang, Fan; Luo, Qiong; Xiong, Zu-ying; Zhao, Ming-hui; Hou, Shuang; Chen, Min
• Is Part Of: Diabetes research and clinical practice. Volume 190(2022)
• Publication Date: 2022-08
• Subjects: Type 2 diabetes mellitus -- Kimmelstiel-Wilson nodules -- Diabetic kidney disease -- End-stage kidney disease; Diabetes -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462
• DOI: 10.1016/j.diabres.2022.109978
• Languages: English
• ISSNs: 0168-8227

Abstract

Abstract: Aims: In the current study, we aimed to investigate the predictive value of the Kimmelstiel-Wilson (K-W) nodule for the risk of ESKD in patients with type 2 diabetes mellitus (T2DM). Methods: In the two-center retrospective study, clinical and pathological parameters were compared between DKD patients with and without K-W nodules. Furthermore, we used Cox regression analysis to explore the predictive value of the K-W nodule for the risk of ESKD. Results: Compared with DKD patients without K-W nodules, patients with K-W nodules had a significantly higher level of proteinuria [5.1(3.1, 8.0) g/24 hr vs . 2.4(1.1, 4.4) g/24 hr, p < 0.001]. Patients with K-W nodules had significantly higher interstitial fibrosis and tubular atrophy (IFTA) and arteriosclerosis scores than those without (p = 0.001 and p = 0.006). Kaplan-Meier analysis showed that the probability of developing ESKD was significantly higher in patients with K-W nodules than in those without (log-rank test, p < 0.001). However, after adjusting closer variables, the K-W nodule was not an independent predictor for the risk of ESKD (p > 0.05). Conclusions: In T2DM patients with DKD, the K-W nodule was associated with a more severe phenotype, and to some extent, associated with poorer renal outcome, but might not be an independent risk factor for the progression of ESKD.