The presence of exudative thickening of Bowman’s capsule predict poor prognosis in diabetic kidney disease
Authors' conclusion
Various mechanisms contribute to Bowman's capsule thickening in DKD. The proportion of exudative thickening may serve as a valuable prognostic indicator for DKD patients.
Study context
- Population
- Diabetic kidney disease (DKD) patients with renal biopsy; discovery cohort with eGFR ≥ 30 ml/min/1.73 m²plus 20 controls
- Participants
- 145 patients
- Exposure
- Exudative vs fibrotic thickening of Bowman's capsule
- Outcome
- Composite of:
- CKD stage 5
- Dialysis initiation
- Renal disease-related death
Methodological detailsrenal biopsy, discovery cohort, two validation cohorts
- Renal biopsy
- Discovery cohort
- Two validation cohorts
Main finding
As reported in the abstract
Composite renal endpoint:
- Discovery cohort
- N=111
- Exudative thickening associated with poor prognosis on Cox multivariate analysis
- Validation cohorts confirmed the result
- Exudative vs Fibrotic thickening: P = 0.000
Observational data: associations, not effects.
Further findings
Bowman's capsule thickness · thicker in DKD
P < 0.01
Types of thickening
- Three types observed: fibrotic, exudative and periglomerular fibrosis; parietal epithelial cell matrix protein accumulation contributed to fibrotic, albumin present in exudative
Original publication
The presence of exudative thickening of Bowman’s capsule predict poor prognosis in diabetic kidney disease. Diabetes Res Clin Pract. Published 24 February 2024. doi:10.
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