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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.
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
URL: http://dx.doi.org/10.1093/ndt/gfn351
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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