Kidney damage in diabetes mellitus

Under construction / Forgotten

This article was marked by its author as Under construction, but the last edit is older than 30 days. If you want to edit this page, please try to contact its author first (you fill find him in the history). Watch the discussion as well. If the author will not continue in work, remove the template {{Under construction}} and edit the page.

Last update: Thursday, 30 Mar 2023 at 8.30 pm.

This article has been translated from WikiSkripta; ready for the editor's review.

Macroangiopathy[edit | edit source]

Affection of large arteries (a. renalis and its branches up to aa. arcuatae) -Atherosclerosis.

Microangiopathy[edit | edit source]

These are diabetické nefropatie –damage to arterioles (hyalinization of vas afferens and efferens) and glomerular capillaries ( diabetic glomerulosclerosis ).

Diabetic glomerulosclerosis[edit | edit source]

In 50% of DM type I, in 15–30% of DM II. type.

Kimmelstiel-Wilson nodular glomerulosclerosis

Microscopic

Thickening of the basal membranes of the glomerular capillaries (more kolagenu, less GAG- increased permeability) and enlargement of the glomeruli;
proliferation of the mesangial matrix between the glomerular capillaries, the matrix has the form of an eosinophilic mass similar to hyaline, it is PAS+, initially it is diffuse, later it forms nodes in part of the glomeruli (nodular diabetic glomerulosclerosis of Kimmelstiel-Wilson )
in more advanced stages, so-called insudative lesions (drop-shaped deposits of plasma proteins with lipids) appear under the parietal sheet of Bowman's capsule and under the glomerular capillaries .

Makroskopicky

At first Hyperemia of the kidney is visible , later fine granulation of the surface and a slight reduction in size, terminally the picture of the so-called end-stage kidney occurs - a non-functional, strongly Atrophic kidney with a coarsely granulated surface, a hard-to-peel capsule and a faded pattern without discernible cortex and medulla.

Tubulointerstitial disorders[edit | edit source]

Inflammatory – more common pyelonephritis up to purulent Necrosis of papillae;
dystrophic - accumulation of glycogen in cells of the proximal tubule (bulky, bright cytoplasm - the so-called Armani zone ), Steatosis of cells and thickening of tubular basement membranes, fibrosis of the interstitium, or the presence of lipophages in the interstitium;
the functional consequences are the development of renal hypertension (overproduction of renin with reduced renal perfusion) and Proteinuria (up to the development of Nephrotic syndrome with Renal failure).

Links[edit | edit source]

Source[edit | edit source]