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- Title
Glomerular structure in type-1 (insulin-dependent) diabetic patients with normo- and microalbuminuria.
- Authors
Walker, James D.; Close, Collin F.; Jones, Sharon L.; Rafftery, Martin; Keen, Harry; Viberti, GianCarlo; Østerby, Ruth
- Abstract
Kidney biopsies from 15 type-1 (insulin-dependent) diabetic patients with a range of albumin excretion (AER) were analysed. Nine patients had normal AER, and six had microalbuminuria. Basement membrane thickness, BMT, and mesangial matrix volume fraction. Vv(mat/glom), were obtained from at least three glomeruli per biopsy. Mesangial structures were estimated with electron microscopic analysis at three levels in each glomerulus. Glomerulopathy parameters were significantly increased in microversus normoalbuminuric patients with the following means and (CV): BMT 571 nm (0.12) and 442 nm (0.25), P = 0.03; Vv(mes/glom) 0.31 (0.20) and 0.22(0.14), P = 0.002: Vv(matrix/glom) 0.17 (0.25) and 0.11 (0.28), P = 0.006; matrix star volume 56 μm3 (0.47) and 22 μm3 (0.43), P = 0.02. A positive correlation obtained between AER and each of the glomerulopathy parameters, BM thickness, Vv(mes/glom) and Vv(matrix/glom), as well as between AER and a structural index expressing the sum of changes in the peripheral BM and in the mesangium (r = 0.62, P = 0.01). The results indicated a parallel course of mesangial and peripheral BM changes: a positive correlation obtained between BM thickness and mesangial parameters [BMT versus Vv(matrix/glom): r = 0.82, P = 0.0001] and (he ratio of the two subsets of glomerular BM material (PBM:matrix) did not show significant difference between normo- and microalbuminuric groups. The data give strong support to the contention that the transition from normo- into the microalbuminuric phase is linked to progressing glomerulopathy.
- Subjects
RENAL biopsy; KIDNEY glomerulus; MORPHOLOGY; PEOPLE with diabetes; ALBUMINS; BASAL lamina
- Publication
Kidney International, 1992, Vol 41, Issue 4, p741
- ISSN
0085-2538
- Publication type
Article
- DOI
10.1038/ki.1992.116