Importance of frequency and morphological characteristics of nodular diabetic glomerulosclerosis in diabetic nephropathy
| Autor: | Megumi Morita, Tomohiro Kaneko, Akira Shimizu, Michiko Aoki, Yukinao Sakai, Fumihiko Yasuda, Masako Tagawa, Sae Aratani, Akiko Mii |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Pathology medicine.medical_specialty 030232 urology & nephrology Renal function 030204 cardiovascular system & hematology urologic and male genital diseases Pathology and Forensic Medicine Diabetic nephropathy Extracellular matrix 03 medical and health sciences 0302 clinical medicine Diabetes mellitus medicine Humans Diabetic Nephropathies Pathological Aged Retrospective Studies Proteinuria business.industry Middle Aged medicine.disease Renal pathology Female medicine.symptom business Kidney disease |
| Zdroj: | Human Pathology. 75:95-103 |
| ISSN: | 0046-8177 |
| DOI: | 10.1016/j.humpath.2018.01.019 |
| Popis: | The Renal Pathology Society proposed a pathological classification for diabetic nephropathy (DN) (RPS 2010). We retrospectively examined the renal structural-functional relationships using the RPS 2010 classification in 49 DN cases. We also evaluated the importance of the percentage of glomeruli with nodular diabetic glomerulosclerosis and their morphological characteristics (cellular, cellular and extracellular matrix [ECM] or ECM types) in the pathology of DN. The classes of DN (RPS 2010) were significantly correlated with the duration of diabetes mellitus (DM), degree of proteinuria, a decreased estimated glomerular filtration rate (eGFR), and the stages of Japanese clinical DM and chronic kidney disease (CKD). When the percentage of glomeruli with nodular glomerulosclerosis (IIIA25%, IIIB 25-50%, IIIC 50-75%, and IIID75%) was added to class III in this classification, the classes of DN had a greater correlation with the levels of proteinuria. The morphological characteristics of nodular glomerulosclerosis such as cellular, cellular and ECM, or ECM type were associated with several clinical parameters including the duration of DM, degree of proteinuria, a decreased eGFR, and/or the stages of clinical DM and CKD. Mesangial red blood cell fragments that is indicative of microvascular injury was found in cellular or cellular and ECM types of nodular glomerulosclerosis. The RPS 2010 classification is useful as a DN pathological classification that indicates a good correlation with the clinical characteristics of DN. In addition, the frequency and morphological characteristics of nodular diabetic glomerulosclerosis is important for the evaluation of the pathology in DN. |
| Databáze: | OpenAIRE |
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