Kidney function and histological damage in autopsy subjects with myocardial infarction
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Published on: February 2, 2021
Shinichiro Niizuma1, Satoko Nakamura, Hatsue Ishibashi-Ueda
1Division of Hypertension and Nephrology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
Insights
In patients with myocardial infarction (MI), significant renal parenchymal damage and declining kidney function were closely linked. This highlights the importance of kidney health in cardiovascular disease outcomes.
Area of Science:
- Nephrology
- Cardiology
- Pathology
Background:
- Chronic kidney disease (CKD) is a significant risk factor for cardiovascular disease (CVD).
- Previous research indicated renal parenchymal damage in autopsy subjects with stroke or abdominal aortic aneurysm.
- Understanding the renal-cardiac link in myocardial infarction (MI) is crucial.
Purpose of the Study:
- To investigate the relationship between renal histology and clinical characteristics in patients who experienced myocardial infarction (MI).
Main Methods:
- Retrospective analysis of 123 autopsy cases with MI.
- Classification of subjects into four groups based on estimated glomerular filtration rate (eGFR) and proteinuria.
- Semi-quantitative histological scoring of renal parenchymal damage (glomerulosclerosis, interstitial fibrosis, tubular atrophy, etc.).
Main Results:
- The mean histological score for renal parenchymal damage was significantly higher in patients with more advanced CKD (eGFR < 60 mL/min/1.73 m²).
- Higher histological scores were associated with increased age, hypertension, diabetes, impaired kidney function, and proteinuria.
- Renal parenchymal damage correlated with other cardiovascular diseases.
Conclusions:
- Renal parenchymal damage and deteriorating kidney function are closely associated in patients with myocardial infarction (MI).
- These findings underscore the interconnectedness of kidney health and cardiovascular outcomes in MI patients.
Objectives:
Chronic kidney disease (CKD) is a major risk factor for cardiovascular disease (CVD). We previously reported renal parenchymal damage in autopsy subjects with stroke or abdominal aortic aneurysm. The aim of this study is to evaluate the relationship between renal histology and clinical characteristics of patients with myocardial infarction (MI).
Methods:
A total of 699 subjects were autopsied at the National Cerebral and Cardiovascular Center Hospital. We retrospectively evaluated all autopsy cases with MI (n = 123). Estimated glomerular filtration rate (eGFR) was calculated using the Japanese formula. Subjects were classified into four groups: 25 subjects with eGFR ≥ 60 mL/min/1.73 m(2) and no proteinuria (no CKD), 10 subjects with eGFR ≥ 60 and proteinuria (CKD1/2), 65 subjects with 60 > eGFR ≥ 30 (CKD3), and 23 subjects with eGFR < 30 (CKD4/5). Renal parenchymal damage was evaluated using a semi-quantitative histological score (score 0-3) for glomerulosclerosis, interstitial fibrosis, tubular atrophy, arteriolar hyalinosis, and arteriosclerosis of medium-sized artery (maximum score = 15).
Results:
The mean histological score was significantly higher in patients with CKD3 and CKD4/5 and was associated with age, hypertension, diabetes, kidney function, proteinuria, and other CVD.
Conclusions:
In patients with MI, renal parenchymal damage and deteriorating kidney function are closely associated.
