Differences in biopsy-proven diabetic kidney disease in individuals from Polynesia vs mainland France: a retrospective cohort study
Main finding · Time from biopsy to kidney failure with replacement therapy (death as competing risk)Result — go to the resultHazard ratio 2.45 95% CI 1.23–4.88Authors' conclusion
Starting at an earlier age, the evolutive course of DKD is also more severe in individuals from French Polynesia than from mainland Western Europe. Strong differences in clinical, histological and predictive outcomes of diabetic nephropathy were found in these different ethnic groups.
Study context
- Population
- Individuals with T2D and biopsy-confirmed diabetic kidney disease (DKD)
- Participants
- 92 vs 63
- Exposure
- French Polynesia vs mainland France
- French Polynesian = 92
- Mainland Francen = 63reference
- Outcome
- Kidney survival (kidney failure with replacement therapy / end stage kidney disease)
Main finding
As reported in the abstract
Hazard ratio
2.45
95% CI 1.23–4.88
By group
Observational data: associations, not effects.
Further findings
Age at biopsy · younger in Polynesia
P < 0.001
Time since diabetes diagnosis · biopsy · shorter in Polynesia
P = 0.008
Urinary protein/creatinine ratio (uPCR) · biopsy · higher in Polynesia
P < 0.001
- Renal Pathology Society (RPS) classification · biopsy · more severe in Polynesia
- P < 0.001
Urinary protein/creatinine ratio (uPCR) · biopsy
- Similar anti-proteinuria treatments and eGFR
Predictors of kidney survival (reduced multivariable model)
- RPS classification more strongly associated with kidney survival in Polynesia; p value for interaction
- 0.048
- Higher uPCR more strongly associated with kidney survival in mainland France; p value for interaction
- <0.001
- Polynesian origin, higher uPCR, lower eGFR, more severe RPS classification and chronic vascular lesions independently associated with poorer kidney survival
Death
- Older age and Polynesian origin were independent risk factors for death
Original publication
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