SAN DIEGO—Vascular lesions found on renal biopsy for diabetic nephropathy may predict development of cardiovascular (CV) events, study findings presented at Kidney Week suggest.

Katsuhiko Morimoto, MD, and colleagues at Nara Medical University in Kashihara, Japan, investigated the relationship between the glomerular or vascular lesions of renal specimens and CV events or end-stage renal disease (ESRD) in 390 patients with type 2 diabetes and biopsy-proven diabetic nephropathy. Patients had a mean age of 57.7 years.

The investigators divided glomerular lesions into 3 groups based on the Renal Pathological Society classification scheme: IIa, IIb, and III–IV. They divided vascular lesions into 2 groups according to the presence or absence of vascular involvement.

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During an average observation period of 9.3 years, CV events occurred in 164 patients and ESRD developed in 71. The presence of vascular lesions in renal tissue independently predicted a 2-fold increased risk of CV events, but was not associated with ESRD. Glomerular lesions were not associated with CV events, but they were an independent risk factor for ESRD. Compared with IIa lesions, IIb and III–IV lesions were associated with a 6-fold and 12-fold increased risk of ESRD.