Glycosuria in glomerular diseases: histopathology and clinical correlations

Woronik, Viktoria; Freitas, Ismael Forte; Saldanha, Luís Balthazar; Sabbaga, E; Marcondes, M

doi:10.1590/s0100-879x1998000500005

Cited by 4 publications

(12 citation statements)

References 16 publications

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“…At the same direction, MN patients with glycosuria presented a more severe disease at diagnosis, including higher IFTA, than non-glycosuria MN patients. Similar studies reported higher prevalence of glycosuria in PG (28%) 2,4 . Our lower prevalence may be associated with the fact that we only accounted as glycosuric patients those with glycosuria at the time of diagnosis, whereas other studies have accounted it when present over various periods of the disease.…”

Section: Discussionsupporting

confidence: 75%

“…Similar to our findings, these studies reported higher SCr levels, higher Ualb, and lower Salb in the glycosuria group. Additionally, they confirmed higher levels of IFTA and worst renal outcomes in patients with glycosuria 2,4 . Some investigations suggest that tubulointerstitial lesions may correlate better with outcomes in PG than glomerular damage itself 10,11 .…”

Section: Discussionmentioning

confidence: 64%

“…Our lower prevalence may be associated with the fact that we only accounted as glycosuric patients those with glycosuria at the time of diagnosis, whereas other studies have accounted it when present over various periods of the disease. Other studies also reported MN as the PG with higher glycosuria prevalence (up to 50%) 4,8 .…”

Section: Discussionmentioning

confidence: 83%

“…It is an extremely easy and inexpensive test. Besides, it seems to correlate with a more severe histological disease 2,4 . Glycosuria is reported to be increasingly more frequent as chronic kidney disease (CKD) progresses 1 .…”

Section: Introductionmentioning

confidence: 95%

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Glycosuria in primary glomerulopathies: prevalence and prognostic significance

et al. 2022

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Introduction: Tubular damage is common in glomerular diseases (GD). Glycosuria is a marker of tubular dysfunction and may be used to detect tubular lesion and CKD progression. The aim of this study was to evaluate the prevalence and prognostic value of glycosuria at the time of diagnosis in primary glomerulopathies (PG). Methods: We conducted a 24-month retrospective study in patients diagnosed with PG in our center between 2009 and 2020. We excluded diabetic patients, use of SGLT2 inhibitors, transplant patients, and secondary GD. Patients were divided in two groups according to their glycosuria status at diagnosis. Results: We studied 115 patients. Global prevalence of glycosuria was 10% (n=11) and membranous nephropathy (MN) had the highest prevalence (n=5, 17.9%). We found that patients with glycosuria had higher serum creatinine (2.4 vs. 1.2 mg/dL, p=0.030), higher albuminuria (4.8 vs. 1.9 g/g, p=0.004), and lower serum albumin (2.3 vs. 3.2 g/dL, p=0.021). We did not find association with histological prognostic factors. At the end of follow-up, patients with glycosuria had higher prevalence of the composite outcome of stage 5D CKD or 50% increase in basal SCr (45.5% vs. 17.3%, p=0.037). In patients with MN, results were similar but we were able to find an association of glycosuria with more severe interstitial fibrosis and tubular atrophy (25.0 vs. 0.0 %, p=0.032). Conclusion: Ten percent of our patients with PG have glycosuria. Glycosuria at the time of diagnosis was associated with more severe clinical presentation and worst renal outcome. The association with higher albuminuria suggests that tubular function has an impact on the severity and outcomes of PG.

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Section: Discussionsupporting

confidence: 75%

Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 83%

Section: Introductionmentioning

confidence: 95%

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Glycosuria in primary glomerulopathies: prevalence and prognostic significance

et al. 2022

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“…In the present study, glycosuria ≥ trace was present in 82% of ATIN patients. In the other renal diseases including glomerular diseases, however, glycosuria may also occur due to the concurrent tubular injury [ 11 , 26 ], and glycosuria ≥ trace was present in 15% of patients with other diagnoses. Thus, glycosuria ≥ trace was not very specific to ATIN.…”

Section: Discussionmentioning

confidence: 99%

Non-diabetic glycosuria as a diagnostic clue for acute tubulointerstitial nephritis in patients with azotemia

Lee

Yang

2020

Renal Failure

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Background: Glycosuria is one of the manifestations of acute tubulointerstitial nephritis (ATIN), but may also be observed in other renal diseases. In this study, we investigated the value of non-diabetic glycosuria as a diagnostic clue for ATIN. Methods: We retrospectively reviewed the medical records of adult patients who underwent a kidney biopsy as an evaluation for serum creatinine > 1.4 mg/dL. Patients with proteinuria in the nephrotic range, diabetes mellitus, or transplanted kidney were excluded. The laboratory abnormalities suggestive of tubular injury were compared between 28 patients (14 men and 14 women, mean age 48.5 ± 14.1 years) with ATIN and 116 patients (76 men and 40 women, mean age 53.1 ± 15.0 years) with other diagnoses. Results: In ATIN, glycosuria (! 1þ on dipstick; 68%) was more frequent than hypophosphatemia (18%), hypouricemia (18%), hypokalemia (18%), and tubular proteinuria (40%). In other diagnoses, glycosuria (! 1þ) was detected in 7 (6%) patients; 6 of them had the histological diagnosis of antineutrophil cytoplasmic antibody-associated glomerulonephritis. The presence of glycosuria (! 1þ) had 68% sensitivity and 94% specificity for ATIN, with the positive likelihood ratio of 11.24 and the negative likelihood ratio of 0.34. Pyuria and low total CO 2 were equally and more sensitive (68% and 71%, respectively) than glycosuria (! 1þ), but had no diagnostic value due to low specificities (58% and 60%, respectively). Conclusion: In non-diabetic, non-nephrotic patients undergoing a kidney biopsy for azotemia, 1þ or higher glycosuria, if present, was a good predictor of the diagnosis of ATIN.

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Non-diabetic urine glucose in idiopathic membranous nephropathy

Liu

Zuo

et al. 2022

Renal Failure

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This study aims to analyze the characteristics of idiopathic membranous nephropathy (iMN) with nondiabetic urine glucose during the follow-up. We retrospectively analyzed the data of 1313 patients who were diagnosed iMN. The prevalence of nondiabetic urine glucose during follow-up was 10.89%. There were significant differences between the patients with nondiabetic urine glucose and those without urine glucose in gender, hypertension ratio, proteinuria, N-acetyl-β-glucosaminidase, retinol binding protein, serum albumin, serum creatinine (Scr), cholesterol, triglyceride and positive anti-phospholipase A2 receptor antibody ratio, glomerular sclerosis ratio, acute and chronic tubular injury lesion at baseline. To exclude the influence of the baseline proteinuria and Scr, case control sampling of urine glucose negative patients was applied according to gender, baseline proteinuria and Scr. The proteinuria nonremission (NR) ratio was 45.83 versus 12.50% of the urine glucose positive group and case control group. Partial remission (PR) ratio of the two groups was 36.46 versus 23.96% and complete remission (CR) ratio was 19.79% versus 63.54%, respectively. Patients with urine glucose had higher risk of 50% estimated glomerular filtration rate (eGFR) reduction. Cox regression showed that urine glucose and baseline Scr were risk factors of 50% reduction of eGFR. Urine glucose remission ratio of the patients with proteinuria NR, PR, and CR was 13.33, 56.25, and 94.73% ( p < 0.005). Patients who got urine glucose remission also had better renal survival. In conclusion, non-diabetic urine glucose was closely related to proteinuria. It could be applied as a tubular injury marker to predict renal function.

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Glycosuria in glomerular diseases: histopathology and clinical correlations

Cited by 4 publications

References 16 publications

Glycosuria in primary glomerulopathies: prevalence and prognostic significance

Glycosuria in primary glomerulopathies: prevalence and prognostic significance

Non-diabetic glycosuria as a diagnostic clue for acute tubulointerstitial nephritis in patients with azotemia

Non-diabetic urine glucose in idiopathic membranous nephropathy

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