Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
September 1, 2026 · via Europe PMC
Clinical phenotype and prognosis of patients with diabetic kidney disease complicated by a primary podocytopathy.
Zhou Y, Wang H, Nie L, Zhao MH, Wang SX.
AI summary — for doctors, generated from the abstract only
Diabetic nephropathy with concurrent primary podocytopathy on electron microscopy is a distinct phenotype that responded to immunosuppression.
What was studied
Retrospective analysis of 88 biopsy-proven DN patients (2017-2022), grouped by foot process width of 821 nm or more, with 7 diabetic non-DN controls.
Key findings
- Patients with podocytopathy had shorter nephropathy duration and lower serum albumin.
- They had nephrotic-range proteinuria and ultrastructural podocyte effacement.
- They showed favorable response to immunosuppressive therapy.
Clinical relevance
Suggests a subgroup of diabetic patients with rapid nephrotic disease might benefit from biopsy and immunosuppression.
Who should care
Limitations
Retrospective single-center with non-randomized treatment, so benefit is not established.
Consider biopsy with foot process assessment in diabetic patients with atypical nephrotic presentations.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Background
Diabetic nephropathy (DN), a leading cause of end-stage kidney disease (ESKD), often progresses despite standard care. Evidence suggests a DN subgroup exhibiting overlapping features of primary podocytopathy, potentially responsive to immunosuppression, that has not yet been systematically studied. We hypothesized that DN patients with biopsy-proven concurrent ultrastructural features of primary podocytopathy will demonstrate superior renal outcomes following immunosuppressive therapy, compared with those with isolated DN pathology.
Methods
A retrospective analysis was conducted on 88 patients with biopsy-confirmed DN recruited from Peking University First Hospital between 2017 and 2022. The patients were categorized into two groups: Group A (patients with DN and primary podocytopathy) and Group B (patients with DN without primary podocytopathy). Seven patients with diabetes and primary podocytopathy but without DN served as disease controls. Primary podocytopathy was defined by electron microscopy foot process width (FPW) ≥821 nm.
Results
Patients in Group A had a shorter duration of nephropathy (P = .005), lower serum albumin levels (P < .001) and higher proteinuria (P = .032) than those in Group B. Light microscopy demonstrated milder glomerular lesions in Group A (P < .001), with most cases classified as Class I or II (63.6%). Electron microscopy showed significantly broader FPW in Group A than in Group B (1310.5 ± 510.1 nm vs 569.1 ± 97.5 nm, P < .001). While Group B showed no such benefit and differed significantly from the control group, patients in Group A benefited from immunosuppressive therapy, with a significantly reduced risk of ESKD.
Conclusion
DN with concurrent primary podocytopathy represents a distinct clinical entity characterized by nephrotic-range proteinuria, ultrastructural podocyte effacement and favorable response to immunosuppressive therapy. Early renal biopsy incorporating FPW assessment enables targeted therapy to mitigate ESKD progression in this high-risk phenotype.
DOI
10.1093/ndt/gfag050
PMID
41818335
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
Want more like this?
Browse more from the feed. A free account unlocks the full feed, saving and communities.
Back to the research feed