Association between renal vascular lesions and echocardiographic indices related to diastolic function in patients with diabetic nephropathy: a biopsy-based cross-sectional study.

چکیده اصلی

AIMS: Renal vascular lesions are common in diabetic nephropathy (DN), but their association with echocardiographic indices related to diastolic function remains unclear. This study investigated the relationship between renal vascular lesion severity and echocardiographic indices in biopsy-confirmed DN. METHODS: This biopsy-based cross-sectional study included 360 patients with biopsy-confirmed DN and available echocardiographic data. Renal vascular lesions were evaluated using a composite score of arteriolar hyalinosis and arteriosclerosis, and patients were categorized into three severity groups (scores 0-1, 2-3, and 4). Echocardiographic indices included E/e', e', and left atrial diameter (LA). Multivariable linear regression models were used to assess the associations between renal vascular lesion severity and echocardiographic parameters. Sensitivity analyses were performed using continuous vascular lesion scores and additional covariate adjustment. RESULTS: Among 360 patients, 53, 253, and 54 were classified into the 0-1, 2-3, and 4 score groups, respectively. Compared with the 0-1 group, moderate and severe vascular lesions were associated with higher E/e' (β = 1.814 and 2.910, respectively) and larger LA (β = 1.722 and 2.917, respectively) after multivariable adjustment. Continuous score analysis showed that each 1-point increase in vascular lesion score was associated with higher E/e', larger LA, and lower e'. Associations with E/e' and LA were generally consistent across sensitivity analyses, whereas the association with e' was less stable. CONCLUSIONS: In patients with biopsy-confirmed DN, greater renal vascular lesion severity was associated with higher E/e' and larger LA, highlighting a potential link between renal vascular pathology and echocardiographic indices related to diastolic function.

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