Diabetes, Metabolic Syndrome and Obesity (Mar 2023)
Clinicopathological Characteristics and Risk Factors for Rapid eGFR Decline in Chinese Patients with Biopsy-Proven Obesity-Related Glomerulopathy
Abstract
Jia Yang,1,2 Qing Yang,1,2,* Yuan Fang,3,* Fang Liu1– 3 1Division of Nephrology, West China Hospital of Sichuan University, Chengdu, People’s Republic of China; 2Laboratory of Diabetic Kidney Disease, Center of Diabetes and Metabolism Research, West China Hospital of Sichuan University, Chengdu, People’s Republic of China; 3Department of Clinical Research Management, West China Hospital of Sichuan University, Chengdu, People’s Republic of China*These authors contributed equally to this workCorrespondence: Fang Liu, Division of Nephrology, West China Hospital of Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan Province, People’s Republic of China, Tel +86-28-18980601214, Fax +86-28-85422335, Email [email protected]: To investigate the clinicopathologic features and the related risk factors for rapid estimated glomerular filtration rate (eGFR) decline in Chinese obesity-related glomerulopathy (ORG) patients.Methods: A total of 63 ORG patients, who underwent a renal biopsy and received follow-up for at least 12 months, were recruited in our study. These patients were classified as rapid decliners and slow decliners based on the eGFR slope value (− 5.0 mL/min/1.73 m2/year). Logistic regression analysis was used to determine the risk factors for rapid eGFR decline.Results: Of the 63 ORG patients, 48 (76.2%) were male, the mean age was 38.7 ± 9.0 years, the median of urinary protein excretion was 1.62 g/24 h, 27.0% of them had nephrotic-range proteinuria, while hypoalbuminemia was observed in 7.9% of them. The incidence of obvious hypertriglyceridemia, hypertension, glucose dysmetabolism and hyperuricemia were 71.4%, 60.3%, 36.5% and 27.0%, respectively. 13 (20.6%) patients became rapid decliners during the median 45 months of follow-up. Their mean BMI was 31.8 ± 3.6 kg/m2, the median of baseline eGFR and urinary protein excretion were 71.8 (range of 30.5– 118.2) mL/min/1.73 m2/year and 3.57 g/24 h, respectively. Multivariate logistic regression analysis showed that smoking (OR 9.205, 95% CI 1.704– 49.740, P = 0.01), hyperuricemia (OR 5.541, 95% CI 1.079– 28.460, P = 0.04) and nephrotic-range proteinuria (OR 6.128, 95% CI 1.311– 28.637, P = 0.021) were the independent risk factors for rapid eGFR decline.Conclusion: Chinese ORG patients were more likely to have clinical characteristics with hypertriglyceridemia, hypertension and hyperuricemia, and mild to severe degrees of urinary protein excretion at diagnosis, while patients with nephrotic-range proteinuria lacked hypoalbuminemia and hypercholesterolemia. Smoking, hyperuricemia and nephrotic-range proteinuria were independent risk factors for rapid eGFR decline in ORG patients.Keywords: obesity-related glomerulopathy, clinical features, rapid eGFR decline, risk factors
