Diabetic nephropathy

Question 1

Diabetic nephropathy?

Answer 1

• commonest cause of end-stage renal disease (ESRD) in the western world
• 33% of patients with type 1 diabetes mellitus have diabetic nephropathy by the age of 40 years
• approximately 5-10% of patients with type 1 diabetes mellitus develop (ESRD)

Question 2

What is the pathophysiology of Diabetic nephropathy?

Answer 2

The pathophysiology is poorly understood, however:

• changes to the haemodynamics of the glomerulus is thought to be key, which leads to an increased glomerular capillary pressure
• histological changes include: basement membrane thickening, capillary obliteration, mesangial widening. Nodulular hyaline areas develop in the glomuli - Kimmelstiel-Wilson nodules

Question 3

Severe arteriolosclerosis is seen in the afferent arteriole on the left of the slide. Multiple, smaller acellular nodules are seen in the glomerulus - Kimmelstiel-Wilson nodules. The tubular basement membrane is also thickened

Answer 3

Question 4

Answer 4

Question 5

Answer 5