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Prevalence of atubular glomeruli in type 2 diabetic patients with nephropathy

Lookup NU author(s): Dr Kathryn White, Emerita Professor Sally Marshall, Professor Rudy Bilous



BACKGROUND: Atubular glomeruli have been identified in a number of chronic renal diseases and have been linked to declining renal function. In type 1 diabetes they are present predominantly in proteinuric patients. We investigated the prevalence of atubular glomeruli in type 2 diabetes and their relationship to renal function. METHODS: Renal biopsies from 12 type 2 diabetic patients with nephropathy were processed for light and electron microscopy and analysed using standard stereological techniques. Abnormalities at the glomerular tubular junction were quantified using an index of junctional atrophy (IJA). RESULTS: There was no relationship between the degree of proteinuria and the presence of atubular glomeruli or atrophic tubules. Creatinine clearance correlated with the IJA (r = -0.70, P = 0.011), percent sclerosed glomeruli (r = -0.59, P = 0.027) and interstitial volume fraction (r = -0.54, P = 0.037). The IJA also correlated with foot process width and volume fraction interstitium (r = 0.58, P = 0.049 for both). Percent sclerosed glomeruli correlated with mesangial (r = 0.65, P = 0.012) and interstitial (r = 0.69, P = 0.007) volume fractions. CONCLUSIONS: In contrast to type 1 diabetes, atubular glomeruli and atrophic tubules occur in type 2 diabetic patients with low levels of proteinuria; their development may influence the progressive change in GFR. Both glomerular and interstitial damage may lead to the development of atubular glomeruli in type 2 diabetic nephropathy.

Publication metadata

Author(s): White KE, Marshall SM, Bilous RW

Publication type: Article

Publication status: Published

Journal: Nephrology Dialysis Transplantation

Year: 2008

Volume: 23

Issue: 11

Pages: 3539-3545

ISSN (print): 0931-0509

ISSN (electronic): 1460-2385

Publisher: Oxford University Press


DOI: 10.1093/ndt/gfn351

Notes: White, Kathryn E Marshall, Sally M Bilous, Rudolf W England Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association Nephrol Dial Transplant. 2008 Nov;23(11):3539-45. Epub 2008 Jun 16.


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