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Diabetic nephropathy: renal structural studies in type 1 and type 2 diabetic patients

机译:糖尿病肾病:1型和2型糖尿病患者的肾脏结构研究

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The clinical manifestations of diabetic nephropathy, proteinuria, decreasing glomerular filtration rate and increasing blood pressure are similar in type 1 and type 2 diabetes, while the renal lesions differ. Indeed, in type 1 diabetes, although also tubular, interstitial and arteriolar lesions are present, the most important structural changes involve the glomerulus, in contrast several type 2 diabetic patients, despite the presence of microalbuminuria or proteinuria, have normal glomerular structure with or without tubulo-interstitial and arteriolar abnormalities. The renal functional parameters are strongly related with the structural changes, especially with the degree of mesangial expansion in both type 1 and type 2 diabetes. Previous studies using light and electron microscopic morphometric analyses described the renal structural changes and the structural-functional relationships of diabetic nephropathy. This review focuses on these topics, documenting the contribution of renal biopsy studies in understanding the pathogenesis of diabetic nephropathy and in identifying the patients with higher risk to progress to end-stage renal disease.
机译:糖尿病肾病,蛋白尿,降低肾小球过滤速率和增加血压的临床表现在1型和2型糖尿病,而肾病区不同。实际上,在1型糖尿病中,虽然还存在管状,间质和动脉膜病变,但最重要的结构变化涉及肾小球,相比之几型糖尿病患者,尽管存在微量白蛋白尿或蛋白尿,具有常规肾小球结构,有或没有微管间和动脉轴异常。肾功能参数与结构变化强烈相关,特别是在1型和2型糖尿病中的梭菌膨胀程度。以前的使用光和电子显微镜形态学分析描述了糖尿病肾病的肾结构结构变化和结构性关系。本综述重点介绍了这些主题,记录了肾活检研究在了解糖尿病肾病发病机制中的贡献,以及鉴定患有更高风险的患者进展到终末期肾病。

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