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Updated: Oct 19, 2025
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Comparative Proteomic Analysis of Whole Kidney, Medulla, and Cortical Tubules in Diabetic Pathogenesis of Kidney Injury in Mice
Published on: May 2, 2025
367
Pathomorphological sequence of nephron loss in diabetic nephropathy
Jana Löwen1,2, Elisabeth F Gröne2, Marie-Luise Groß-Weißmann3
1Department of Neuroanatomy, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany.
American Journal of Physiology. Renal Physiology
|September 20, 2021
Summary
Diabetic nephropathy (DN) involves GBM accumulation and leaky glomerular vessels, leading to glomerular sclerosis. A key pathway to nephron loss involves capillary penetration into Bowman
Area of Science:
- Nephrology
- Pathology
- Diabetic Complications
Background:
- Previous studies identified mesangial sclerosis and vascular proliferation in diabetic nephropathy (DN).
- This study investigates the advanced stages of DN, including glomerular obsolescence and tubulointerstitial fibrosis.
Purpose of the Study:
- To describe the structural aberrations in advanced diabetic nephropathy.
- To elucidate the mechanisms leading to glomerular degeneration and tubulointerstitial fibrosis.
Main Methods:
- Analysis of 918 human kidney biopsies.
- Histopathological examination to identify structural changes in diabetic nephropathy.
Main Results:
- Two primary defects identified: increased glomerular basement membrane (GBM) synthesis and defective glomerular vessels.
- Accumulation of worn-out GBM material leads to mesangial sclerosis and glomerular obsolescence.
- Glomerular capillary penetration into Bowman's capsule (BC) causes exudation, leading to sclerosis and secondary tubulointerstitial damage.
Conclusions:
- Accumulation of GBM material in the mesangium is a key feature of advanced DN.
- A common pathway to nephron loss involves glomerular capillaries entering BC, causing widespread damage.
- Glomerular damage initiates tubulointerstitial fibrosis through secondary tubule degeneration.
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