Fast Five Quiz: Diabetic Nephropathy Presentation and Diagnosis

A. Brent Alper, Jr, MD, MPH


April 24, 2020

According to the classification scheme for diabetic nephropathy from the Renal Pathology Society, clinical or pathologic evidence of diabetic nephropathy plus > 50% global glomerulosclerosis on biopsy is characteristic of class IV (advanced diabetic glomerulosclerosis) diabetic nephrology.

Nodular sclerosis (class III) consists of ≥ 1 Kimmelstiel-Wilson lesions, none of the changes described in class IV, and no more than 50% global glomerulosclerosis on biopsy.

Isolated glomerular basement membrane is characteristic of class I (glomerular basement membrane thickening) diabetic nephropathy.

Kimmelstiel-Wilson lesions are not seen in class II diabetic nephropathy (mesangial expansion); mild or severe mesangial expansion in the glomeruli is present in this stage, with no more than 50% of glomeruli demonstrating global glomerulosclerosis.

Learn more about the diagnosis and classification of diabetic nephropathy.

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