Complement activation in patients with diabetic nephropathy

Li, X.-Q.; Chang, Dong‐Yuan; Chen, M.; Zhao, Ming‐Hui

doi:10.1016/j.diabet.2018.04.001

Cited by 69 publications

(75 citation statements)

References 40 publications

(15 reference statements)

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“…It should be pointed out that the present finding of a close correlation between urinary CAPs and renal tubular interstitial injury is quite different from the results obtained by Li et al . For the present, we cannot explain the causes.…”

Section: Discussioncontrasting

confidence: 99%

“…reported urinary CAP levels in 50 biopsy‐proven DN patients. However, with the mean eGFR being 44.28 mL/min/1.73 m (44.28 ± 26.79 mL/min/1.73 m) and mean proteinuria being 6.33 g/24 h (6.33 ± 4.35 g/24 h), most of the patients included in the study by Li et al . still belonged to the advanced stage of DN.…”

Section: Discussionmentioning

confidence: 99%

“…By using the renal biopsy specimen and the urine samples from patients with different stages of DN, the present study investigated the pathological significance of urinary complement activation in the development of DN. Increased urinary CAPs have been reported in some renal diseases including DN. In 1991, Ogrodowski et al .…”

Section: Discussionmentioning

confidence: 99%

“…Quite different from the studies carried out by Ogrodowski et al . and Morita et al ., in a recently published study, Li et al . reported urinary CAP levels in 50 biopsy‐proven DN patients.…”

Section: Discussionmentioning

confidence: 99%

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Pathological significance of urinary complement activation in diabetic nephropathy: A full view from the development of the disease

Zheng

Jiang²,

Chen³

et al. 2018

J of Diabetes Invest

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Aims/Introduction The aim of the present study was to obtain a full view of the changes of urinary complement activation products in the development of diabetic nephropathy and explore their possible significance in the disease process. Materials and methods A total of 62 patients at different stages of diabetic nephropathy, 20 diabetes patients without nephropathy and 20 healthy persons were enrolled. Urinary complement activation products, including C3a, C5a and C5b‐9, were measured, and their associations with the progression of the disease were analyzed. Results The urinary complement activation products increased markedly since the proteinuria stage, and were parallel with the progression of diabetic nephropathy. More severe renal tubular damage was observed in patients with higher levels of urinary complement activation products. The urinary complement activation products levels correlated closely with renal tubulointerstitial injury score and relative tubular interstitial volume. Multivariate regression analysis showed that elevated urinary complement activation products were independent risk factors for tubular injury in diabetic nephropathy patients. Conclusions Urinary complement activation might have a role in renal tubular interstitial injury in patients with diabetic nephropathy, especially in patients at a later stage of the disease.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Pathological significance of urinary complement activation in diabetic nephropathy: A full view from the development of the disease

Zheng

Jiang²,

Chen³

et al. 2018

J of Diabetes Invest

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show abstract

“…Whether this is the result of complement deposition on severely damaged tissues or secondary complement deposition directly accelerates kidney injury caused by diabetic injury is yet to be clarified. Several studies have shown that glomerular complement split products are seen in patients with DN, and the complement system may have a role in disease process …”

Section: Discussionmentioning

confidence: 99%

Predictors and histopathological characteristics of non‐diabetic renal disorders in diabetes: a look from the tubulointerstitial point of view

Heybeli

Oktan

Arda

et al. 2019

Internal Medicine Journal

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Background Prevalence and characteristics of non‐diabetic renal diseases (NDRD) in patients with type 2 diabetes mellitus is different between populations, and seems to be largely dependent on biopsy policies. Aim To investigate clinical clues for NDRD in patients with type 2 diabetes mellitus and to analyse renal prognosis of patients based on pathological diagnosis. Methods We retrospectively searched medical records of 115 patients with type 2 diabetes who underwent a renal biopsy between 2004 and 2018. Patients were divided into three groups as diabetic nephropathy (DN), NDRD + DN or NDRD based on histopathological examination. Results Thirty‐six (31.3%) patients had DN, 33 (28.7%) had DN + NDRD and 46 (40%) had NDRD. The absence of diabetic retinopathy, recent onset of diabetes, abnormal disease chronology, and blood haemoglobin was associated with the presence of NDRD in univariate analysis. Abnormal disease chronology which was defined as the presence of acute proteinuria and/or acute kidney injury that are unexpected to be related to evolution of diabetic nepropathy (odds ratio 4.65, 95% confidence interval 1.44–15.00; P = 0.010) and absence of diabetic retinopathy (odds ratio 3.44, 95% confidence interval 1.32–8.98; P = 0.012) were independently associated with the presence of NDRD in multivariate analysis. Focal segmental glomerulosclerosis was the most frequent type of NDRD. Diseases that affect tubulointerstitial area were more prevalent in the DN + NDRD group compared to the NDRD group (P = 0.001). Renal survival, which was defined as evolution to end‐stage renal disease, was 59.5 ± 14.4 months, 93.7 ± 11.7 months and 87.2 ± 2.6 months for DN, DN + NDRD and NDRD groups, respectively (P = 0.005). Conclusions Renal biopsy is essential in certain clinical conditions as diagnosis of NDRD is vital for favourable renal survival. DN may facilitate superimposed tubular injury in the presence of toxic insults.

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Complement Activation in Progression of Chronic Kidney Disease

Chen

2019

Advances in Experimental Medicine and Biology

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Complement activation in patients with diabetic nephropathy

Abstract: In DN patients, the complement system is activated and, of the three possible complement pathways, activation of the lectin and alternative pathways is associated with renal damage.

Cited by 69 publications

References 40 publications

Pathological significance of urinary complement activation in diabetic nephropathy: A full view from the development of the disease

Pathological significance of urinary complement activation in diabetic nephropathy: A full view from the development of the disease

Predictors and histopathological characteristics of non‐diabetic renal disorders in diabetes: a look from the tubulointerstitial point of view

Complement Activation in Progression of Chronic Kidney Disease

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