Smoking as the potential link between Kimmelstiel-Wilson lesion and non-diabetic nodular glomerulosclerosis in male patients -a single center retrospective study

Richárd Halmai, Péter Degrell, István András Szijártó, Viktória Mátyás, Gergo Attila Molnár, Tibor Kovács, I. Wittmann

Research output: Contribution to journalArticle

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Abstract

Background: The histological pattern of nodular glomerulosclerosis (NGS) can be found both in diabetic nephropa-thy (Kimmelstiel-Wilson (KW) lesion) and non-diabetic nodular glomerulosclerosis (non-diab NGS). Chronic smoking is considered to be a potential cause of non-diab NGS, but the prevalence of smokers in KW is unknown. Methods: In a retrospective analysis, native renal biopsy specimens (n = 644, 2001 - 2011) were evaluated and male patients' characteristics, including smoking habits, were assessed within three groups: diabetic patients with KW (n = 15), diabetic patients with other classes of diabetic nephropathy (non-KW; n = 46), and patients with non-diab NGS (n = 7). Results: The majority of patients in the KW and non-diab NGS groups (13/15 = 87%, 7/7 = 100%, respectively; p = 1.0 vs. KW) were smokers, unlike the non-KW group (16/46 = 35%; p = 0.001 vs. KW). Cigarette pack-years showed a similar pattern (KW: 15 (6 - 30), non-KW: 0 (0 - 21), non-diab NGS: 30 (16 - 33); p = 0.010 non-KW vs. KW, p = 0.008 non-KW vs. non-diab NGS). Other known factors responsible for the worsening of non-KW or the development of non-diab NGS did not differ in the groups (age, body mass index, duration of diabetes mellitus, HbA1c, prevalence of hypertension, duration of hypertension, serum cholesterol, triglycer-ide, estimated glomerular fltration rate, and renin-angiotensin-aldosteron system-blocker treatment). Conclusions: We propose that chronic cigarette smoking could play a pivotal role in the development of KW lesions.

Original languageEnglish
Pages (from-to)23-28
Number of pages6
JournalClinical Nephrology
Volume80
Issue number1
DOIs
Publication statusPublished - 2013

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Diabetic Nephropathies
Retrospective Studies
Smoking
Hypertension
Renin-Angiotensin System
Tobacco Products
Habits
Diabetes Mellitus
Body Mass Index
Age Groups
Cholesterol
Kidney
Biopsy
Serum

Keywords

  • Chronic cigarette smoking
  • Nodular glomeruloscle-rosis

ASJC Scopus subject areas

  • Nephrology

Cite this

Smoking as the potential link between Kimmelstiel-Wilson lesion and non-diabetic nodular glomerulosclerosis in male patients -a single center retrospective study. / Halmai, Richárd; Degrell, Péter; Szijártó, István András; Mátyás, Viktória; Molnár, Gergo Attila; Kovács, Tibor; Wittmann, I.

In: Clinical Nephrology, Vol. 80, No. 1, 2013, p. 23-28.

Research output: Contribution to journalArticle

Halmai, Richárd ; Degrell, Péter ; Szijártó, István András ; Mátyás, Viktória ; Molnár, Gergo Attila ; Kovács, Tibor ; Wittmann, I. / Smoking as the potential link between Kimmelstiel-Wilson lesion and non-diabetic nodular glomerulosclerosis in male patients -a single center retrospective study. In: Clinical Nephrology. 2013 ; Vol. 80, No. 1. pp. 23-28.
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T1 - Smoking as the potential link between Kimmelstiel-Wilson lesion and non-diabetic nodular glomerulosclerosis in male patients -a single center retrospective study

AU - Halmai, Richárd

AU - Degrell, Péter

AU - Szijártó, István András

AU - Mátyás, Viktória

AU - Molnár, Gergo Attila

AU - Kovács, Tibor

AU - Wittmann, I.

PY - 2013

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N2 - Background: The histological pattern of nodular glomerulosclerosis (NGS) can be found both in diabetic nephropa-thy (Kimmelstiel-Wilson (KW) lesion) and non-diabetic nodular glomerulosclerosis (non-diab NGS). Chronic smoking is considered to be a potential cause of non-diab NGS, but the prevalence of smokers in KW is unknown. Methods: In a retrospective analysis, native renal biopsy specimens (n = 644, 2001 - 2011) were evaluated and male patients' characteristics, including smoking habits, were assessed within three groups: diabetic patients with KW (n = 15), diabetic patients with other classes of diabetic nephropathy (non-KW; n = 46), and patients with non-diab NGS (n = 7). Results: The majority of patients in the KW and non-diab NGS groups (13/15 = 87%, 7/7 = 100%, respectively; p = 1.0 vs. KW) were smokers, unlike the non-KW group (16/46 = 35%; p = 0.001 vs. KW). Cigarette pack-years showed a similar pattern (KW: 15 (6 - 30), non-KW: 0 (0 - 21), non-diab NGS: 30 (16 - 33); p = 0.010 non-KW vs. KW, p = 0.008 non-KW vs. non-diab NGS). Other known factors responsible for the worsening of non-KW or the development of non-diab NGS did not differ in the groups (age, body mass index, duration of diabetes mellitus, HbA1c, prevalence of hypertension, duration of hypertension, serum cholesterol, triglycer-ide, estimated glomerular fltration rate, and renin-angiotensin-aldosteron system-blocker treatment). Conclusions: We propose that chronic cigarette smoking could play a pivotal role in the development of KW lesions.

AB - Background: The histological pattern of nodular glomerulosclerosis (NGS) can be found both in diabetic nephropa-thy (Kimmelstiel-Wilson (KW) lesion) and non-diabetic nodular glomerulosclerosis (non-diab NGS). Chronic smoking is considered to be a potential cause of non-diab NGS, but the prevalence of smokers in KW is unknown. Methods: In a retrospective analysis, native renal biopsy specimens (n = 644, 2001 - 2011) were evaluated and male patients' characteristics, including smoking habits, were assessed within three groups: diabetic patients with KW (n = 15), diabetic patients with other classes of diabetic nephropathy (non-KW; n = 46), and patients with non-diab NGS (n = 7). Results: The majority of patients in the KW and non-diab NGS groups (13/15 = 87%, 7/7 = 100%, respectively; p = 1.0 vs. KW) were smokers, unlike the non-KW group (16/46 = 35%; p = 0.001 vs. KW). Cigarette pack-years showed a similar pattern (KW: 15 (6 - 30), non-KW: 0 (0 - 21), non-diab NGS: 30 (16 - 33); p = 0.010 non-KW vs. KW, p = 0.008 non-KW vs. non-diab NGS). Other known factors responsible for the worsening of non-KW or the development of non-diab NGS did not differ in the groups (age, body mass index, duration of diabetes mellitus, HbA1c, prevalence of hypertension, duration of hypertension, serum cholesterol, triglycer-ide, estimated glomerular fltration rate, and renin-angiotensin-aldosteron system-blocker treatment). Conclusions: We propose that chronic cigarette smoking could play a pivotal role in the development of KW lesions.

KW - Chronic cigarette smoking

KW - Nodular glomeruloscle-rosis

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