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DIABETIC NEPHROPATHY

Most common cause of chronic renal failure

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Glomerular lesions• Capillary basement membrane

thickening• Diffuse glomerulosclerosis• Nodular glomeruloscierosis

(Kimmelstiel Wilson syndrome)‑

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Glomerular capillary basement membranes

• Thickened •May be present without any

associated change in renal function.

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Diffuse glomerulosclerosis

• Diffuse increase in mesangial matrix. • Always associated with basement

membrane thickening. • Found in most patients with DM > 10

years. • Presents as nephrotic syndrome.

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Interstitial fibrosis• Tubules - perfused by vessels arising

from efferent arterioles. • Glomerulosclerosis - tubular ischemia

and interstitial fibrosis.

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Earliest abnormality in diabetic nephropathy

• Thickening of the glomerular basement membrane

• Accumulation of extracellular matrix.

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