PROJECTS

     
ENBiBA: European Nephrectomy Bio-Bank
 
Summary

The epidemic of obesity and type 2 diabetes (T2DM) may portend severe consequences in nephrology. Obesity and diabetes represent a continuum of metabolic alterations which can greatly increase the chance of renal disease. Common markers of renal damage in diabetes and obesity include i.e. insulin resistance, hypertension, prediabetic alterations in glucose metabolism, insulin resistance, hyperuricaemia, dyslipidemia and lipotoxicity, chronic sub-clinical inflammation, unhealthy obesity, glomerular hyperfiltration and albuminuria. Renal histological changes associated with obesity (metabolically healthy or unhealthy) and early diabetic nephropathy are mostly unknown. The major limitation for studying early histological changes of obesity and diabetes is that renal biopsies are not performed due to ethical concerns. To solve this limitation, we propose the creation of a bio-bank of unaffected renal tissue of pieces of nephrectomy, to study the following points: (a) the histological pattern of renal damage in the whole spectrum of obesity (not only extreme obesity); (b) histological changes in healthy and unhealthy obesity with the same degree of BMI; (c) similarities in renal histology between early diabetes and metabolically unhealthy obesity; (d) the impact of metabolic factors on obesity-related renal damage; (e) possible pathogenetic pathways i.e. lipotoxicity or sub-clinical inflammation in obesity driven renal disease; (f) the prevalence of markers of chronic disease i.e. glomerulsclerosis, tubular and interstitial fibrosis in patients with obesity and early diabetes. This also will give the possibility of analyzing pathogenetic pathways involved in renal damage associated with these diseases.

 

At the moment 250 cases have been recruited and preliminary results including renal histology of patients with diabetes without proteinuria as well as in patients with metabolic syndrome have been shown at the last educational meeting of DIABESITY that was held in Lisbon (Portugal) last November 2017. The group is currently preparing the first manuscript of ENBiBA describing the presence of features of diabetic nephropathy in patients with diabetes without proteinuria or prediabetes.
 
If you are interested in the ENBiBA project, send an e-mail to:
enbiba@diabesity.ecihucan.es
.