Back
For best output, select "Paper Size" as "A4" and "Margin" as "0" or "None".
To save or print to PDF, please select Print Destination > Save as PDF, enable Background Graphics under "More Settings", then click "Save".
During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Diabetic kidney disease (DKD) remains the leading cause of end-stage renal disease (ESRD) and early intervention is important from a health economic perspective. Although various histopathological lesions have been reported to associate with renal function decline, their relative contributions to renal prognosis in detail remain unclear. In this study, we aimed to clarify the clinical background and characteristics of renal pathological findings in DKD patients exhibiting a rapid decline in estimated glomerular filtration rate (eGFR). We also examined the association between various pathological findings and renal prognosis.
We retrospectively analyzed 48 patients who underwent renal biopsy and were diagnosed with DKD in our hospital from April 2013 to March 2023 and whose clinical course could be followed for two years after biopsy. Rapid decline in eGFR was defined as a decrease in eGFR of more than 5 ml/min/1.73 m2 a year during two years after diagnosis . Clinical and histopathological features were compared between patients with rapid and non-rapid decline in eGFR. The relationships between pathological lesions and renal outcomes were evaluated using Kaplan–Meier and Cox proportional hazards analyses, with dialysis initiation as the primary endpoint.
The median (IQR: Interquartile Range) age was 62.1 (54.0-70.3) years and 46 patients had type 2 diabetes. Patients with rapid decline in eGFR (N = 25) had higher urinary protein (p< 0.05), higher urinary β₂-microglobulin (p< 0.05) compared to those with non-rapid decline. Histologically, the index of arteriolar hyalinosis (Moriya et al, Diabetes Care 2017) and interstitial fibrosis score were significantly higher in patients with rapid decline (p< 0.05). Kaplan–Meier analysis showed that advanced interstitial fibrosis was associated with shorter dialysis-free survival (log-rank p< 0.05). In univariate Cox analysis, interstitial fibrosis (HR = 2.61, 95% CI 1.07–6.39, p< 0.05) and urinary β₂-microglobulin (p< 0.05) were significant predictors of dialysis initiation. Multivariate analysis identified interstitial fibrosis as an independent risk factor (HR = 2.61, 95% CI 1.07–6.39, p< 0.05). Urinary β₂-microglobulin positively correlated with serum creatinine (R = 0.433, p< 0.05) and interstitial fibrosis (R = 0.324, p< 0.05).
Among patients with DKD, interstitial fibrosis was the strongest predictor of renal prognosis and independently associated with dialysis initiation in this study. Urinary β₂-microglobulin may serve as a non-invasive marker reflecting the progression of interstitial injury. These findings underscore the importance of tubulointerstitial damage in determining renal outcome in DKD.
