Which changes in the glomeruli are characteristic of diabetic nephropathy?

Updated: Oct 09, 2019
  • Author: Vecihi Batuman, MD, FASN; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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The following three major histologic changes occur in the glomeruli of persons with diabetic nephropathy:

  • First, mesangial expansion is directly induced by hyperglycemia, perhaps via increased matrix production or glycosylation of matrix proteins.

  • Second, thickening of the glomerular basement membrane (GBM) occurs.

  • Third, glomerular sclerosis is caused by intraglomerular hypertension (induced by renal vasodilatation or from ischemic injury induced by hyaline narrowing of the vessels supplying the glomeruli).

These different histologic patterns appear to have similar prognostic significance.

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