Capillaroscopic appearance of nailfold vasculature of diabetic nephropathy patients

Abstract

Objectives: Diabetic nephropathy is a microvascular complication of diabetes and the most common cause of end-stage renal failure throughout the world. Videocapillaroscopy is a simple and noninvasive method that can display capillaries in the nail bed at the micron level. A few studies have been conducted on detecting retinopathy, another important diabetic microvascular complication, with videocapillaroscopy; however, no comprehensive study has been performed on diabetic nephropathy. We aimed to determine the relationship between nephropathy and capillaroscopic changes. Subjects and methods: Capillaroscopic findings of 144 patients with type 2 diabetes and 88 healthy controls were assessed prospectively by nailfold videocapillaroscopy. Twelve capillaroscopic findings were evaluated in all subjects. Results: Patients with albuminuria had more capillary aneurysms (15.5%), more microhemorrhages (15.5%), greater tortuosity (76.3%), more neoformations (29.9%), more bizarre capillaries (49.5%) and more bushy capillaries (20.6%) than the control group. In logistic regression analysis, tortuosity was significantly correlated with albuminuria (OR: 2.451, p = 0.048). Conclusions: Our findings show that the application of nailfold videocapillaroscopy can detect microvascular abnormalities in the nail bed that occur in diabetes mellitus patients compared to healthy people. Although there was no difference in the microvascular changes among the stages of diabetic nephropathy, a relationship between tortuosity and albuminuria was identified by logistic regression analysis. Nailfold videocapillaroscopy may be a new application that can be used to screen the microvascular changes that occur in diabetes mellitus.

Capillaroscopic changes in patients with glomerular diseases: a case control study

“…In the present study there was statistically signi cant difference between GN and control group as regard capillary shape with higher percent of tortious capillaries among GN group. This was in concordance with the results of previous study conducted on 144 patients with diabetic nephropathy and reported that patients with proteinuria had higher incidence of tortious capillaries than normoalbuminuric patients and healthy control group (31). In other two studies, tortious capillaries had higher prevalence in patients with diabetic nephropathy and diabetic microangiopathy than healthy control (34) (35).…”

“…Capillary hemorrhage was more frequent in patients with GN than healthy control group and this was similar to the results of previous study which demonstrated signi cant difference in capillary hemorrhage between diabetic patients with proteinuria and those without proteinuria (31). However other studies failed to demonstrate signi cant difference between patients with renal disease and diabetic nephropathy in one hand and healthy control group in the other hand (32) (36) (34).…”