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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Cite this: A. Brent Alper. Fast Five Quiz: Diabetic Nephropathy Presentation and Diagnosis - Medscape - Apr 24, 2020.
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