White blood cell fractions correlate with lesions of diabetic kidney disease and predict loss of kidney function in Type 2 diabetes

Kevin M. Wheelock, Pierre Jean Saulnier, Stephanie K. Tanamas, Pavithra Vijayakumar, E. Jennifer Weil, Helen C. Looker, Robert L. Hanson, Kevin V. Lemley, Berne Yee, William C. Knowler, Samy Hadjadj, Behzad Najafian, Michael Mauer, Robert G. Nelson

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background Inflammation linked to diabetic kidney disease (DKD) may affect white blood cell (WBC) counts and differentials. We examined the cross-sectional associations of total WBC count and WBC fractions with structural lesions of DKD in 108 Pima Indians with Type 2 diabetes who underwent research kidney biopsies. 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. Methods Associations of WBC variables with morphometric parameters were assessed by linear regression. RFL was defined as≥40% loss of estimated glomerular filtration rate from baseline. Associations with RFL were evaluated by Cox regression. Hazard ratios (HRs) were reported per standard deviation increment of each WBC variable. Results After multivariable adjustment, lymphocyte (r = -0.20, P = 0.043) and eosinophil (r = 0.21, P = 0.032) fractions in the Pima Indians correlated with glomerular basement membrane width. Eosinophil fraction also correlated with glomerular filtration surface density (r = -0.21, P = 0.031). Lymphocyte fraction (r = 0.25, P = 0.013), neutrophil fraction (r = -0.23, P = 0.021) and the neutrophil:lymphocyte ratio (r = -0.22, P = 0.024) correlated with percentage of normally fenestrated endothelial cells. During median follow-up of 4.5 years, 321 SURDIAGENE participants developed RFL. Lower lymphocyte fraction [HR = 0.67, 95% confidence interval (95% CI) 0.60-0.76] and higher neutrophil fraction (HR = 1.35, 95% CI 1.20-1.52), total WBC count (HR = 1.20, 95% CI 1.08-1.35) and neutrophil:lymphocyte ratio (HR = 1.44, 95% CI 1.28-1.62) each predicted RFL in this cohort. Conclusions WBC fractions associate with morphometric lesions of DKD and predict RFL in individuals with Type 2 diabetes.

Original languageEnglish (US)
Pages (from-to)1001-1009
Number of pages9
JournalNephrology Dialysis Transplantation
Volume33
Issue number6
DOIs
StatePublished - Jun 1 2018

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Diabetic Nephropathies
Type 2 Diabetes Mellitus
Leukocytes
Kidney
Lymphocytes
Neutrophils
Leukocyte Count
Confidence Intervals
Potassium Iodide
Eosinophils
Glomerular Basement Membrane
Glomerular Filtration Rate
Linear Models
Endothelial Cells
Inflammation
Biopsy
Research

Keywords

  • CKD
  • biomarkers
  • diabetic kidney disease
  • inflammation
  • kidney biopsy

PubMed: MeSH publication types

  • Journal Article
  • Research Support, Non-U.S. Gov't

Cite this

Wheelock, K. M., Saulnier, P. J., Tanamas, S. K., Vijayakumar, P., Weil, E. J., Looker, H. C., ... Nelson, R. G. (2018). White blood cell fractions correlate with lesions of diabetic kidney disease and predict loss of kidney function in Type 2 diabetes. Nephrology Dialysis Transplantation, 33(6), 1001-1009. https://doi.org/10.1093/ndt/gfx231

White blood cell fractions correlate with lesions of diabetic kidney disease and predict loss of kidney function in Type 2 diabetes. / Wheelock, Kevin M.; Saulnier, Pierre Jean; Tanamas, Stephanie K.; Vijayakumar, Pavithra; Weil, E. Jennifer; Looker, Helen C.; Hanson, Robert L.; Lemley, Kevin V.; Yee, Berne; Knowler, William C.; Hadjadj, Samy; Najafian, Behzad; Mauer, Michael; Nelson, Robert G.

In: Nephrology Dialysis Transplantation, Vol. 33, No. 6, 01.06.2018, p. 1001-1009.

Research output: Contribution to journalArticle

Wheelock, KM, Saulnier, PJ, Tanamas, SK, Vijayakumar, P, Weil, EJ, Looker, HC, Hanson, RL, Lemley, KV, Yee, B, Knowler, WC, Hadjadj, S, Najafian, B, Mauer, M & Nelson, RG 2018, 'White blood cell fractions correlate with lesions of diabetic kidney disease and predict loss of kidney function in Type 2 diabetes', Nephrology Dialysis Transplantation, vol. 33, no. 6, pp. 1001-1009. https://doi.org/10.1093/ndt/gfx231
Wheelock, Kevin M. ; Saulnier, Pierre Jean ; Tanamas, Stephanie K. ; Vijayakumar, Pavithra ; Weil, E. Jennifer ; Looker, Helen C. ; Hanson, Robert L. ; Lemley, Kevin V. ; Yee, Berne ; Knowler, William C. ; Hadjadj, Samy ; Najafian, Behzad ; Mauer, Michael ; Nelson, Robert G. / White blood cell fractions correlate with lesions of diabetic kidney disease and predict loss of kidney function in Type 2 diabetes. In: Nephrology Dialysis Transplantation. 2018 ; Vol. 33, No. 6. pp. 1001-1009.
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abstract = "Background Inflammation linked to diabetic kidney disease (DKD) may affect white blood cell (WBC) counts and differentials. We examined the cross-sectional associations of total WBC count and WBC fractions with structural lesions of DKD in 108 Pima Indians with Type 2 diabetes who underwent research kidney biopsies. 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. Methods Associations of WBC variables with morphometric parameters were assessed by linear regression. RFL was defined as≥40{\%} loss of estimated glomerular filtration rate from baseline. Associations with RFL were evaluated by Cox regression. Hazard ratios (HRs) were reported per standard deviation increment of each WBC variable. Results After multivariable adjustment, lymphocyte (r = -0.20, P = 0.043) and eosinophil (r = 0.21, P = 0.032) fractions in the Pima Indians correlated with glomerular basement membrane width. Eosinophil fraction also correlated with glomerular filtration surface density (r = -0.21, P = 0.031). Lymphocyte fraction (r = 0.25, P = 0.013), neutrophil fraction (r = -0.23, P = 0.021) and the neutrophil:lymphocyte ratio (r = -0.22, P = 0.024) correlated with percentage of normally fenestrated endothelial cells. During median follow-up of 4.5 years, 321 SURDIAGENE participants developed RFL. Lower lymphocyte fraction [HR = 0.67, 95{\%} confidence interval (95{\%} CI) 0.60-0.76] and higher neutrophil fraction (HR = 1.35, 95{\%} CI 1.20-1.52), total WBC count (HR = 1.20, 95{\%} CI 1.08-1.35) and neutrophil:lymphocyte ratio (HR = 1.44, 95{\%} CI 1.28-1.62) each predicted RFL in this cohort. Conclusions WBC fractions associate with morphometric lesions of DKD and predict RFL in individuals with Type 2 diabetes.",
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T1 - White blood cell fractions correlate with lesions of diabetic kidney disease and predict loss of kidney function in Type 2 diabetes

AU - Wheelock, Kevin M.

AU - Saulnier, Pierre Jean

AU - Tanamas, Stephanie K.

AU - Vijayakumar, Pavithra

AU - Weil, E. Jennifer

AU - Looker, Helen C.

AU - Hanson, Robert L.

AU - Lemley, Kevin V.

AU - Yee, Berne

AU - Knowler, William C.

AU - Hadjadj, Samy

AU - Najafian, Behzad

AU - Mauer, Michael

AU - Nelson, Robert G.

PY - 2018/6/1

Y1 - 2018/6/1

N2 - Background Inflammation linked to diabetic kidney disease (DKD) may affect white blood cell (WBC) counts and differentials. We examined the cross-sectional associations of total WBC count and WBC fractions with structural lesions of DKD in 108 Pima Indians with Type 2 diabetes who underwent research kidney biopsies. 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. Methods Associations of WBC variables with morphometric parameters were assessed by linear regression. RFL was defined as≥40% loss of estimated glomerular filtration rate from baseline. Associations with RFL were evaluated by Cox regression. Hazard ratios (HRs) were reported per standard deviation increment of each WBC variable. Results After multivariable adjustment, lymphocyte (r = -0.20, P = 0.043) and eosinophil (r = 0.21, P = 0.032) fractions in the Pima Indians correlated with glomerular basement membrane width. Eosinophil fraction also correlated with glomerular filtration surface density (r = -0.21, P = 0.031). Lymphocyte fraction (r = 0.25, P = 0.013), neutrophil fraction (r = -0.23, P = 0.021) and the neutrophil:lymphocyte ratio (r = -0.22, P = 0.024) correlated with percentage of normally fenestrated endothelial cells. During median follow-up of 4.5 years, 321 SURDIAGENE participants developed RFL. Lower lymphocyte fraction [HR = 0.67, 95% confidence interval (95% CI) 0.60-0.76] and higher neutrophil fraction (HR = 1.35, 95% CI 1.20-1.52), total WBC count (HR = 1.20, 95% CI 1.08-1.35) and neutrophil:lymphocyte ratio (HR = 1.44, 95% CI 1.28-1.62) each predicted RFL in this cohort. Conclusions WBC fractions associate with morphometric lesions of DKD and predict RFL in individuals with Type 2 diabetes.

AB - Background Inflammation linked to diabetic kidney disease (DKD) may affect white blood cell (WBC) counts and differentials. We examined the cross-sectional associations of total WBC count and WBC fractions with structural lesions of DKD in 108 Pima Indians with Type 2 diabetes who underwent research kidney biopsies. 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. Methods Associations of WBC variables with morphometric parameters were assessed by linear regression. RFL was defined as≥40% loss of estimated glomerular filtration rate from baseline. Associations with RFL were evaluated by Cox regression. Hazard ratios (HRs) were reported per standard deviation increment of each WBC variable. Results After multivariable adjustment, lymphocyte (r = -0.20, P = 0.043) and eosinophil (r = 0.21, P = 0.032) fractions in the Pima Indians correlated with glomerular basement membrane width. Eosinophil fraction also correlated with glomerular filtration surface density (r = -0.21, P = 0.031). Lymphocyte fraction (r = 0.25, P = 0.013), neutrophil fraction (r = -0.23, P = 0.021) and the neutrophil:lymphocyte ratio (r = -0.22, P = 0.024) correlated with percentage of normally fenestrated endothelial cells. During median follow-up of 4.5 years, 321 SURDIAGENE participants developed RFL. Lower lymphocyte fraction [HR = 0.67, 95% confidence interval (95% CI) 0.60-0.76] and higher neutrophil fraction (HR = 1.35, 95% CI 1.20-1.52), total WBC count (HR = 1.20, 95% CI 1.08-1.35) and neutrophil:lymphocyte ratio (HR = 1.44, 95% CI 1.28-1.62) each predicted RFL in this cohort. Conclusions WBC fractions associate with morphometric lesions of DKD and predict RFL in individuals with Type 2 diabetes.

KW - CKD

KW - biomarkers

KW - diabetic kidney disease

KW - inflammation

KW - kidney biopsy

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