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White blood cell fractions seen as potential marker for loss of kidney function in patients with type 2 diabetes
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According to a study that examined Pima Indians with type 2 diabetes, white blood cell fractions were linked with morphometric lesions of diabetic kidney disease and predicted loss of renal function.
“Markers of inflammation are important determinants of diabetic kidney disease, and this study illustrates that a simple marker of inflammation that is widely available – the complete blood count – associates with the early structural lesions of diabetic kidney disease and with loss of kidney function in those with diabetes.” Robert G. Nelson, MD, PhD, co-author of the study, told Healio Nephrology. “Careful examination of kidney tissue suggests there is signaling between circulating white cells and endothelial cells in the glomerulus, and a better understanding of this signaling may help us identify an early mechanism of progressive kidney disease.”
Researchers assessed the associations of white blood cell (WBC) variables with morphometric parameters using linear regression. Renal function loss was defined as more than 40% loss of estimated glomerular filtration rate, and associations with renal function loss were evaluated by Cox regression.
“We examined the cross-sectional associations of total WBC count and WBC fractions with structural lesions of [diabetic kidney disease] DBD in 108 Pima Indians with type 2 diabetes who underwent research kidney biopsies,” the researchers wrote. “We also examined the longitudinal association of these WBC variables with renal function loss (RFL) in 941 Europeans with type 2 diabetes from the SURDIAGENE study.”
After multivariable adjustment, the researchers found:
- lymphocyte and eosinophil fractions in the Pima Indians were associated with glomerular basement membrane width;
- eosinophil fraction correlated with glomerular filtration surface density; and
- lymphocyte fraction, neutrophil fraction and the neutrophil:lymphocyte ratio were linked to the normally fenestrated endothelial cells percentage.
Of the SURDIAGENE participants, 321 developed renal failure loss during a median follow-up of 4.5 years. Lower lymphocyte fraction and higher neutrophil fraction, total white blood cell count and neutrophil:lymphocyte ratio were all predictors for renal function loss. – by Jake Scott
Disclosures: The authors report no relevant financial disclosures.
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