Pathologic classification of diabetic nephropathy
| Autor: | Tervaert, T.W.C., Mooyaart, A.L., Amann, K., Cohen, A.H., Cook, H.T., Drachenberg, C.B., Ferrario, F., Fogo, A.B., Haas, M., Heer, E. de, Joh, K., Noel, L.H., Radhakrishnan, J., Seshan, S.V., Bajema, I.M., Bruijn, J.A., Renal Pathology Soc |
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| Rok vydání: | 2010 |
| Předmět: |
Pathology
medicine.medical_specialty business.industry Glomerular basement membrane Kidney Glomerulus Lupus nephritis General Medicine medicine.disease structural-functional relationships basement-membrane nephropathy renal biopsies glomerulosclerosis insulin mellitus glomerulopathy patterns glomerulonephritis pathogenesis Nephropathy Diabetic nephropathy medicine.anatomical_structure Focal segmental glomerulosclerosis Nodular sclerosis Renal pathology Nephrology medicine Humans Diabetic Nephropathies business Kidney disease |
| Zdroj: | Journal of the American Society of Nephrology, 21(4), 556-563 Journal of the American Society of Nephrology |
| ISSN: | 1533-3450 |
| Popis: | Although pathologic classifications exist for several renal diseases, including IgA nephropathy, focal segmental glomerulosclerosis, and lupus nephritis, a uniform classification for diabetic nephropathy is lacking. Our aim, commissioned by the Research Committee of the Renal Pathology Society, was to develop a consensus classification combining type 1 and type 2 diabetic nephropathies. Such a classification should discriminate lesions by various degrees of severity that would be easy to use internationally in clinical practice. We divide diabetic nephropathy into four hierarchical glomerular lesions with a separate evaluation for degrees of interstitial and vascular involvement. Biopsies diagnosed as diabetic nephropathy are classified as follows: Class I, glomerular basement membrane thickening: isolated glomerular basement membrane thickening and only mild, nonspecific changes by light microscopy that do not meet the criteria of classes II through IV. Class II, mesangial expansion, mild (IIa) or severe (IIb): glomeruli classified as mild or severe mesangial expansion but without nodular sclerosis (Kimmelstiel-Wilson lesions) or global glomerulosclerosis in more than 50% of glomeruli. Class III, nodular sclerosis (Kimmelstiel Wilson lesions): at least one glomerulus with nodular increase in mesangial matrix (Kimmelstiel Wilson) without changes described in class IV. Class IV, advanced diabetic glomerulosclerosis: more than 50% global glomerulosclerosis with other clinical or pathologic evidence that sclerosis is attributable to diabetic nephropathy. A good interobserver reproducibility for the four classes of DN was shown (intraclass correlation coefficient = 0.84) in a test of this classification. |
| Databáze: | OpenAIRE |
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