Abstract: SA-PO1111
Value of Histopathologic Assessment for Nephrosclerosis in Predicting Kidney Function Decline
Session Information
- CKD: Epidemiology, Risk Factors, and Prevention - 3
October 26, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Lee, Haekyung, Soonchunhyang University Hospital, Seoul, Korea (the Republic of)
- Kwon, Soon hyo, Soonchunhyang University Hospital, Seoul, Korea (the Republic of)
- Noh, Hyunjin, Soonchunhyang University Hospital, Seoul, Korea (the Republic of)
Background
Accurate prediction of kidney failure risk is crucial for the effective management of kidney diseases. While demographic and laboratory parameters have been utilized to stratify the risk of kidney failure, the potential of histopathologic assessments—specifically evaluating chronic changes such as glomerulosclerosis, interstitial fibrosis, tubular atrophy, and arteriosclerosis—to improve the prediction of kidney function decline remains to be elucidated.
Methods
This study retrospectively analyzed patients who underwent native kidney biopsy from 2014 to 2022 at Soonchunhyang University Seoul Hospital in South Korea. Two kidney pathologists performed semiquantitative visual inspections for glomerulosclerosis, interstitial fibrosis, tubular atrophy, and arteriosclerosis. We evaluated the value of these histopathologic changes in predicting the risk of a decrease in estimated glomerular filtration rate (eGFR) by 30% or more.
Results
Among 491 patients, 183 (37.3%) experienced a decrease in eGFR by 30% or more. Multivariable analyses, which included demographic and laboratory parameters, revealed that severe tubular atrophy (>50%) (hazard ratio [HR] 2.74, 95% CI 1.68–4.46, P < 0.001) and severe interstitial fibrosis (>50%) (HR 2.09, 95% CI 1.31–3.34, P = 0.002) were independently associated with the risk of an eGFR decline of 30% or more. Additionally, incorporating these histopathologic changes into traditional clinical parameters significantly improved the prediction of eGFR decline.
Conclusion
The integration of histopathologic assessments of chronic kidney changes into clinical information significantly improves the prognostic assessment of eGFR decline. This suggests that histopathologic evaluation of chronic kidney changes should be considered to improve risk stratification in patients with kidney diseases.