Glomerulosclerosis
Widespread vascular abnormalities occur frequently in long standing diabetes (diabetic microangiopathy). These differ from the hypertensive and atheromatous vascular changes and are situated in the peripheral arteries and veins, the arteries to the peripheral nerves, the renal arteries, glomerular arteries of many other organs. Diabetic glomerulosclerosis is clinically recognizable as a varying combination of proteinuria, oedema and hypertension with or without azotaemia. The histological picture is often characterized by a mixture of glomerulosclerosis, interstitial nephropathy hence the condition is referred to as ‘Diabetic Nephropathy’ and renal arteriosclerosis. The term ‘Kimmelstiel Wilson syndrome’ is applied to the clinical picture of nephritic syndrome in a diabetic with nodular glomerulosclerosis. The prevalence of diabetic glomerulosclerosis as revealed by renal biopsy studies in long-standing diabetics, showing albuminuria, with hypertension, retinopathy, azotaemia, etc.
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