Table 7.
Comparison of clinical, LM, and EM characteristics between clusters
| Variables | Cluster 1 (n = 26) | Cluster 2 (n = 11) | Cluster 3 (n = 25) | P values |
|---|---|---|---|---|
| Clinical characteristics | ||||
| Gender (male/female), n (%) | 18(69.2)/8(30.8) | 8(72.7)/3(27.3) | 16(64)/9(36) | 0.9 |
| Age (y) | 56.05 ± 10.77 | 52.36 ± 12.33 | 51.12 ± 14.26 | 0.36 |
| Race, n (%) | 0.6 | |||
| White | 16 (61.5) | 6 (54.5) | 16 (64) | |
| African American | 7 (27) | 4(36.4) | 8 (32) | |
| Asian | 3 (11.5) | 1(9.1) | 0 | |
| American Indian | 0 | 0 | 1 (4) | |
| Type of DM (I/II), n (%) | 3(11.5)/23(88.5) | 0/11 (100) | 3(12)/22(88) | 0.48 |
| Duration of DM (y) | 15.08 ± 10.8 | 14 ± 7.78 | 17.04 ± 12.83 | 0.71 |
| Follow-up time (mo) | 10.62 ± 5.44 | 10.36 ± 3.88 | 10.56 ± 5.27 | 0.99 |
| BMI-Baseline (kg/ | 34.82 ± 6.6 | 30.89 ± 6.43 | 34.64 ± 8.72 | 0.13 |
| BMI-Follow-up (kg/ | 33.84 ± 6.27 | 30.86 ± 6.84 | 35.23 ± 10.67 | 0.36 |
| SBP-Baseline (mm Hg) | 136.54 ± 24.26 | 147.73 ± 24.18 | 142.52 ± 18.65 | 0.34 |
| SBP-Follow-up (mm Hg) | 135 ± 18.4 | 141 ± 20.53 | 137.72 ± 22 | 0.7 |
| DBP-Baseline (mm Hg) | 74.88 ± 11.52 | 79.18 ± 16.73 | 77.28 ± 11.58 | 0.6 |
| DBP-Follow-up (mm Hg) | 75.54 ± 10.86 | 76.45 ± 12.64 | 73.92 ± 12.65 | 0.81 |
| HbA1C (%) | 7.68 ± 1.44 | 7.79 ± 2.13 | 8.1 ± 2.05 | 0.71 |
| eGFR-Baseline (ml/min per 1.73 | 39.2 ± 17.03 | 33.46 ± 21.2 | 25.84 ± 11.84 | 0.01 |
| eGFR-Follow-up (ml/min per 1.73 | 36.67 ± 15.11 | 15.27 ± 11.99 | 17.08 ± 7.75 | 0.0001 |
| eGFR change (%/y) | -8.15 (35) | -72.5 (69) | -34.92 (44) | 0.005 |
| UPCR-Baseline (mg/g) | 1340 (4130) | 10820 (9190) | 6250 (5600) | 0.002 |
| UPCR-Follow-up (mg/g) | 1100 (4240) | 6670 (15730) | 7400 (7560) | 0.04 |
| UPCR fold change (/y) | 1.59 (5.15) | 0.99 (0.97) | 1.37 (2.28) | 0.54 |
| ESKD Progression, n (%) | 1 (4) | 6 (54.5) | 10 (38.5) | 0.002 |
| LM Characteristics | ||||
| KW Nodules (No/Yes), n (%) | 14 (53.8)/12 (46.2) | 0/11(100) | 2(8)/23(92) | 0.0001 |
| RPS DN Class (1/2/3/4), n (%) | 2(7.7)/11(42.3)/11(42.3)/2(7.7) | 0/0/5(45.5)/6(54.5) | 0/1(4)/19(76)/5(20) | 0.0001 |
| Segmental Sclerosis (0/1/2/3/4), n (%) | 18(69.2)/8(30.8)/0/0/0 | 6(54.5)/4(36.4)/1(9.1)/0/0 | 5(20)/17(68)/1(4)/2(8)/0 | 0.01 |
| Global Sclerosis (0/1/2/3/4), n (%) | 2(7.7)/13(50)/9(34.6)/2(7.7)/0 | 0/2(18.2)/2(18.2)/3(27.2)/4(36.4) | 0/7(28)/12(48)/3(12)/3(12) | 0.01 |
| Glomerular Epithelial Hypertrophy (0/1/2/3), n (%) | 23(88.5)/3(11.5)/0/0 | 0/11(100)/0/0 | 24(96)/1(4)/0/0 | 0.0001 |
| Glomerular Epithelial Hyperplasia (0/1/2/3), n (%) | 25(96.1)/1(3.9)/0/0 | 2(18.2)/9(81.8)/0/0 | 24(96)/1(4)/0/0 | 0.0001 |
| Mesangiolysis (No/Yes), n (%) | 26(100)/0 | 2(18.2)/9(81.8) | 12(48)/13(52) | 0.0001 |
| Insudative lesion (No/Yes), n (%) | 26(100)/0 | 3(27.3)/8(72.7) | 8(32)/17(68) | 0.0001 |
| Interstitial Fibrosis, 0–25%/25%–50%/50%–75%/75%–100%, n (%) | 9 (34.6)/13 (50)/2 (7.7)/2 (7.7) | 1 (9.1)/2 (18.2)/2 (18.2)/6 (54.5) | 1 (4)/4 (16)/13 (52)/7 (28) | 0.0001 |
| Interstitial Lymphocyte (0/1/2/3), n (%) | 1(3.8)/12(46.2)/13(50)/0 | 0/2(18.2)/8(72.7)/1(9.1) | 1(4)/2(8)/18(72)/4(16) | 0.04 |
| Arteriolar Hyalinosis (0/1/2/3), n (%) | 10(38.5)/15(57.7)/0/1(3.8) | 1(9.1)/5(45.4)/4(36.4)/1(9.1) | 0/7(28)/12(48)/6(24) | 0.0001 |
| Intimal Fibrosis (0/1/2/3), n (%) | 0/12(46.1)/12(46.1)/2(7.8) | 0/3(27.3)/5(45.5)/3(27.3) | 0/5(20)/10(40)/10(40) | 0.07 |
| EM Characteristics | ||||
| Avg GBM thickness (nm) | 690.19 ± 183.88 | 910.45 ± 230.16 | 814.56 ± 157.84 | 0.003 |
| GBM Lamina Densa Remodeling (0/1/2/3), n (%) | 13(50)/10(38.5)/0/3(11.5) | 6(54.5)/4(36.4)/1(9.1)/0 | 8(32)/10(40)/1(4)/6(24) | 0.34 |
| GBM Duplication (0/1/2/3), n (%) | 20(76.9)/4(15.4)/0/2(7.7) | 5(45.5)/4(36.4)/2(18.2)/0 | 12(48)/7(28)/1(4)/5(20) | 0.05 |
| Avg FPW (μm) | 1.51 ± 0.68 | 2.69 ± 1.15 | 1.89 ± 0.74 | 0.001 |
| Foot process effacement (0–25%/25%–50%/50%–75%/75%–100%), n (%) | 5 (19.2)/7 (26.9)/11 (42.4)/3 (11.5) | 0/2 (18.2)/4 (36.4)/5 (45.5) | 0/5 (20)/14 (56)/6 (24) | 0.06 |
| Endothelial fenestration loss (0/1/2/3), n (%) | 4(15.4)/15(57.7)/7(26.9)/0 | 2(18.2)/2(18.2)/6(54.5)/1(9.1) | 0/18(72)/4(16)/3(12) | 0.01 |
| Mesangial hyaline (0/1/2/3), n (%) | 16(61.5)/7(27)/1(3.8)/2(7.7) | 2(18.2)/4(36.3)/5(45.5)/0 | 5(20)/8(32)/4(16)/8(32) | 0.001 |
| Mesangial matrix increase (0/1/2/3), n (%) | 0/4(15.4)/9(34.6)/13(50) | 0/0/1(9.1)/10(90.9) | 0/0/1(4)/24(96) | 0.002 |
Avg FPW, average foot process width; Avg GBM, average glomerular basement membrane; BMI, body mass index; DBP, diastolic blood pressure; eGFR, estimated glomerular filtration rate; EM, electron microscopy; ESKD, end-stage kidney disease; KW, Kimmelstiel-Wilson Nodule; LM, light microscopy; RPS DN class, Renal Pathology Society diabetic nephropathy class; SBP, systolic blood pressure; UPCR, urine protein to creatinine ratio.