Related Experiment Videos
Early glomerulopathy is present in young, type 1 (insulin-dependent) diabetic patients with microalbuminuria
H J Bangstad1, R Osterby, K Dahl-Jørgensen
1Aker Diabetes Research Center, Aker University Hospital, Oslo, Norway.
Abstract:
Increased urinary albumin excretion, microalbuminuria, may be the first sign of early diabetic nephropathy. We examined glomeruli by morphometric methods in 17 patients with Type 1 (insulin-dependent) diabetes mellitus and microalbuminuria. The median age was 19 (range 18-29) years, duration of diabetes 12 (8-15) years, mean blood pressure 93 (87-115) mm Hg, glomerular filtration rate 132 (101-209) ml.min-1.1.73 m2 -2, albumin excretion rate (mean over 1 year) 32 (15-194) micrograms/min. Reference data were obtained from 11 healthy kidney donors. Mesangial volume estimates were obtained by serial sectioning in three total profiles in each of three glomeruli in diabetic patients. Basement membrane thickness and matrix volume fraction were estimated from one level per glomerulus. Two matrix parameters, matrix star volume and matrix thickness, were estimated. Interstitial volume fraction in cortex was measured by light microscopy. The morphological parameters were significantly increased in the diabetic group compared to the control group, basement membrane thickness (mean with 95% confidence intervals) was 595 nm (549-641 nm) vs 305 nm (287-325 nm), p = 0.0001; mesangial volume fraction 0.22 (0.21-0.23) vs 0.19 (0.18-0.21), p = 0.04, and matrix volume fraction 0.13 (0.12-0.13 vs 0.09 (0.08-0.10), p = 0.001. Also matrix star volume and thickness, interstitial volume fraction and mean capillary diameter were significantly increased. The intra-individual variation among glomeruli expressed as coefficient of variation was 7.4% vs 9% (basement membrane thickness) and 11.7% vs 25% (mesangial volume fraction) in the diabetic and the control group, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
Insights
Diabetic nephropathy, indicated by microalbuminuria, shows significant glomerular changes in Type 1 diabetes patients. Morphometric analysis revealed increased basement membrane thickness and mesangial matrix in diabetic kidneys compared to healthy controls.
Area of Science:
- Nephrology
- Diabetology
- Pathology
Background:
- Microalbuminuria is an early indicator of diabetic nephropathy.
- Type 1 diabetes mellitus (T1DM) can lead to significant kidney damage.
- Understanding early structural changes in diabetic kidneys is crucial for intervention.
Purpose of the Study:
- To investigate glomerular morphometric changes in patients with T1DM and microalbuminuria.
- To compare these changes with healthy kidney donors.
- To identify specific structural alterations associated with early diabetic nephropathy.
Main Methods:
- Morphometric analysis of glomeruli from 17 T1DM patients with microalbuminuria.
- Comparison with glomeruli from 11 healthy kidney donors.
- Measurement of basement membrane thickness, mesangial volume, and matrix parameters.
Main Results:
- Significantly increased basement membrane thickness (595 nm vs 305 nm) in T1DM patients.
- Elevated mesangial volume fraction (0.22 vs 0.19) and matrix volume fraction (0.13 vs 0.09) in T1DM patients.
- Increased matrix star volume, matrix thickness, interstitial volume fraction, and mean capillary diameter observed.
Conclusions:
- Early diabetic nephropathy in T1DM is characterized by significant glomerular structural abnormalities.
- These findings highlight the pathological basis of microalbuminuria in T1DM.
- Morphometric analysis provides valuable insights into the progression of diabetic kidney disease.