Presentation
Here, we present three patients with edema, heavy proteinuria, chronic renal failure, in whom no past or present symptomatic glucose intolerance or diabetic retinopathy were found. [ncbi.nlm.nih.gov]
Entire Body System
- Amyloidosis
In contrast, nodules can also be seen in deposition diseases such as amyloidosis. [ajkdblog.org]
Nodular glomerulosclerosis may be idiopathic or develop associated with diabetes mellitus, membranoprolipherative glomerulonephritis, light or heavy chain deposits, amyloidosis, fibrillary or immunotactoide disease, and Takayasu's arteritis. [ncbi.nlm.nih.gov]
Small series of patients subjected to KTX No patient lost the graft because of transplant amyloidosis 29 Plasma cell dyscrasias Patients with plasma cell dyscrasias and end-stage renal disease (ESRD) may be candidates for kidney transplantation if their [slideplayer.com]
[…] glomerulosclerosis or Kimmelstiel-Wilson disease; ovoid, spherical, laminated hyaline masses in peripheral of glomerulus, PAS+, eventually obliterates glomerular tuft; specific for diabetes and membranoproliferative glomerulonephritis, light chain disease and amyloidosis [pathologyoutlines.com]
A differential diagnosis is amyloidosis, associated with enlarged glomeruli but poor staining with PAS and silver stain. [renalfellow.org]
- Weakness
Immunofluoresence will typically confirm diabetic nephropathy via a weak linear basement membrane IgG staining, whereas MIDD or light chain amyloidosis will be restricted to the abnormal light chain clone. [ajkdblog.org]
These lesions may represent early stages of glomerular disease or be induced by LC with a weak pathogenic potential. Their diagnosis would be unrecognized without the immunostaining results. [kidneypathology.com]
Case A 34-year-old Hispanic woman with an increased body mass index (BMI, 33.7 Kg/m 2 ), hypothyroidism, and kidney disease presented to the emergency room with headache, generalized weakness, and new onset hypertension. [pulmonarychronicles.com]
- Pallor
The physical examination was unremarkable, except by blood pressure of 140/70 mmHg, body mass index of 22.1 kg/m2, and pallor. [ncbi.nlm.nih.gov]
Cardiovascular
- Hypertension
ING is a very rare clinicopathological disease associated with smoking, obesity and hypertension, chronic obstructive pulmonary disease and metabolic syndrome. [ncbi.nlm.nih.gov]
But, hypertension, smoking, obesity, intermittent hyperglycemia predating the diagnosis of diabetes possibly explain the development of nodular glomerulosclerosis in these patients. [jhu.pure.elsevier.com]
Kimmelstiel-Wilson syndrome - nephrotic syndrome and hypertension in diabetics, associated with diabetic glomerulosclerosis. Synonym(s): Kimmelstiel-Wilson disease Wilson, Clifford, English physician, 1906–. [medical-dictionary.thefreedictionary.com]
Psychiatrical
- Suggestibility
Both appear quite similar with H&E staining, but the top right image shows the nodules staining positive on silver staining suggestive of diabetic nephropathy. [ajkdblog.org]
This is a valuable case of ING that suggests the existence of as-yet unknown causative factors of ING other than smoking, hypertention or obesity. [ncbi.nlm.nih.gov]
Neurologic
- Confusion
The features of nephropathy in type 2 diabetes are quite heterogeneous, which can sometimes be confusing to clinicians. [ekjm.org]
As the patient ages, the cysts may become more spherical and the disease can be confused withADPKD. Interstitial fibrosis is also seen as renal function deteriorates. [aippg.net]
- Asthenia
CASE REPORT A 44-year-old woman who was current smoker (25 packs/year), with hypertension and peripheral arterial disease diagnosed 2 and 1 years ago, respectively, presented with asthenia, nausea, and vomiting during the previous 2 weeks. [ncbi.nlm.nih.gov]
Urogenital
- Renal Injury
Patients with metabolic syndrome should be screened for evidence of renal injury since clinical and histological nodular glomerulosclerosis identical to diabetic nephropathy can occur in this setting. [ncbi.nlm.nih.gov]
Further supporting the central role of hypertension in renal injury is the fact that progressive renal injury only occurs when hypertension is superimposed on obesity or diabetes. [mdpi.com]
Management Patients with metabolic syndrome should be screened for evidence of renal injury since clinical and histological nodular glomerulosclerosis identical to diabetic nephropathy can occur in this setting. [nature.com]
- Nocturia
[…] associated with an increased risk of death in general, particularly from cardiovascular disease. [11] [14] Signs and symptoms [ edit ] The onset of symptoms is 5 to 10 years after the disease begins. [1] A usual first symptom is frequent urination at night: nocturia [en.wikipedia.org]
Reflux nephropathy Congenital vesicoureteral reflux Posterior urethral valves Acetaminophen (Paracetamol)overdose Urolithiasis ANSWER CASE NUMBER 12 [ImageScope] [WebScope] Clinical History: A 65-year-old woman had experienced increasing malaise with nocturia [web.duke.edu]
Loss of tubular function--in particular of concentrating ability--gives rise to polyuria and nocturia. Radiographic studies show asymmetrically contracted kidneys with characteristic coarse scars and blunting and deformity of the calyceal system. [aippg.net]
Workup
Since there were no clinical or workup evidences of DM, the patients was diagnosed with ING. 4, 8 IF showed no typical deposits; only non-specific C3 deposits in vessels and sclerotic sites and poor linear pattern IgG deposits in glomeruli were seen. [scielo.br]
[…] essential thrombocythemia Compare and contrast the clinical and pathologic features of: polycythemia vera relative polycythemia secondary polycythemia Describe the proper mode of submission of a lymph node biopsy to the surgical pathology laboratory for workup [web.duke.edu]
(See Workup.) The overall prevalence of microalbuminuria and macroalbuminuria in both types of diabetes is approximately 30-35%. [emedicine.medscape.com]
X-Ray
- Small Kidney
Pathogenesis begins with small vessel disease. [merckmanuals.com]
- Pericardial Effusion
Proteinuria never fell below 5 g/day; maintenance hemodialysis was initiated due to the development of pericardial effusion, considered a uremic symptom. [ekjm.org]
Serum
- Nodular Glomerulosclerosis
RESULTS: Nodular glomerulosclerosis was found in 37.6%. [ncbi.nlm.nih.gov]
- Hyperglycemia
But, hypertension, smoking, obesity, intermittent hyperglycemia predating the diagnosis of diabetes possibly explain the development of nodular glomerulosclerosis in these patients. [jhu.pure.elsevier.com]
but some factors other than hyperglycemia may be responsible for renal damage in our patients. [ncbi.nlm.nih.gov]
- Hypoalbuminemia
Serum protein electrophoresis confirmed the presence of hypoalbuminemia (22.8 g/l), the total protein was 56 g/l and demonstrated polyclonal elevation of the gamma-globulins (13 g/l). The cholesterol was 4.1 µmol/l and triglycerides was 1.1 mmol/l. [casesjournal.biomedcentral.com]
The onset of disease is usually rapid, and it is characterized by massive proteinuria, hypoalbuminemia, hyperlipidemia, generalized edema, and as visualized by light microscopy, minimal glomerular changes [ 11 ]. [omicsonline.org]
Nephrotic syndrome describes the onset of heavy proteinuria (>3.0 g/24 h), hypertension,hypercholesterolemia, hypoalbuminemia, edema/anasarca, and microscopic hematuria;if only large amounts of proteinuria are present without clinical manifestations, [aippg.net]
Other laboratory data not shown in the table are: microhematuria in 25 out of 30 cases, hyperuricemia/gout in 12 out of 33 cases (37%), peripheral vasculopathy in 14 out of 42 patients (33%), hypoalbuminemia in nine out of 44 patients (21%) and three [mdpi.com]
- Creatinine Increased
Dose should be decreased if symptoms of orthostatic hypotension develop or serum creatinine increases by more than 30%. [merckmanuals.com]
However, over a 9-month period, serum creatinine increased gradually from 2.4 to 6.3 mg/dL. Proteinuria never fell below 5 g/day; maintenance hemodialysis was initiated due to the development of pericardial effusion, considered a uremic symptom. [ekjm.org]
Four years previously, nephrology analysis diagnosed probable nephroangiosclerosis (serum creatinine of 1.7 mg/dL, albuminuria/creatinine ratio 50 mg/g, normal sized kidneys with increased cortical echogenicity and normal renal Doppler). [mdpi.com]
- Creatinine Increased
Dose should be decreased if symptoms of orthostatic hypotension develop or serum creatinine increases by more than 30%. [merckmanuals.com]
However, over a 9-month period, serum creatinine increased gradually from 2.4 to 6.3 mg/dL. Proteinuria never fell below 5 g/day; maintenance hemodialysis was initiated due to the development of pericardial effusion, considered a uremic symptom. [ekjm.org]
Four years previously, nephrology analysis diagnosed probable nephroangiosclerosis (serum creatinine of 1.7 mg/dL, albuminuria/creatinine ratio 50 mg/g, normal sized kidneys with increased cortical echogenicity and normal renal Doppler). [mdpi.com]
Other Pathologies
- Lymphocytic Infiltrate
In trichrome staining, a moderate level of tubular atrophy and lymphocyte infiltration was found in the interstitium, with a moderate level of fibrosis. Thus, staining indicated only a moderate level of chronic inflammation. [ekjm.org]
Treatment
Early diagnosis and treatment of albuminuria could alter the course of disease progression. [ncbi.nlm.nih.gov]
Treatment can slow the process of kidney disease. Everyone is different in how they respond to treatment. [kidney.org]
And the FDA has not approved any drugs specifically for its treatment. But several treatments can slow its progression and control symptoms. [webmd.com]
Prognosis
60.3 ± 15.8 0.162 Good Prognosis 54.5 ± 15.9 Proteinuria * Bad prognosis 3.6 ± 2.8 0.584 Good Prognosis 3.9 ± 2.1 eGFR * Bad prognosis 16.3 ± 6.5 <0.001 Good Prognosis 58.7 ± 29.9 The most frequent histological data in DNND is arteriolar hyalinosis/sclerosis [mdpi.com]
List the three major thrombotic microangiopathies ; describe the renal effects and pathogenesis in terms of: microscopic appearance clinical presentation, course, and prognosis Discuss renal vein thrombosis in terms of: etiology/pathogenesis morphology [web.duke.edu]
After diagnosis, SHaNGS has a poor prognosis for renal function. [ncbi.nlm.nih.gov]
SLE Nephropathy Degree of kidney involvement correlates with prognosis in SLE. Anti ds-DNA antibodies. WHO I: Normal WHO II: Increased mesangial matrix WHO III: Focal proliferation WHO IV: Diffuse proliferation, worst. [kumc.edu]
Etiology
Exact etiology for the development of non-diabetic glomerulosclerosis is unclear. [jhu.pure.elsevier.com]
Epidemiology
New chapters on glomerulonephritis associated with complement disorders, interventional treatments for hypertension, renal disease and cancer, and epidemiology and prognostic impact of acute kidney injury. [books.google.de]
International statistics Striking epidemiologic differences exist even among European countries. [emedicine.medscape.com]
[…] nephropathy is the most common cause of end-stage kidney disease, [11] [12] which may require hemodialysis or even kidney transplantation. [13] It is associated with an increased risk of death in general, particularly from cardiovascular disease. [11] [14] Epidemiology [en.wikipedia.org]
Further evidence from the Pittsburgh Epidemiology of Diabetes Complication Study. Kidney Int. 2002, 62, 963–970. [mdpi.com]
Pathophysiology
Each disease-oriented section begins with an up-to-date review of pathophysiology and then focuses on specific diseases. [books.google.de]
Concepts in Diabetic Nephropathy: From Pathophysiology to Treatment. [jrenhep.com]
PMID 19970254. ^ "Diabetic Nephropathy: Background, Pathophysiology, Etiology". 2015-06-20. ^ a b Blázquez-Medela AM, López-Novoa JM, Martínez-Salgado C (March 2010). "Mechanisms involved in the genesis of diabetic nephropathy". [en.wikipedia.org]
[…] course, and prognosis Discuss renal vein thrombosis in terms of: etiology/pathogenesis morphology method(s) of diagnosis clinical and laboratory features Discuss urolithiasis in terms of: composition and relative incidence of various types of stones pathophysiologic [web.duke.edu]
Prevention
The ability of MSCs to repair damaged mesangium represents a novel therapeutic intervention to reverse mesangial injury and is potentially a powerful and unique approach to prevent progression ending in end-stage renal disease (ESRD). [ncbi.nlm.nih.gov]
Screening for microalbuminuria and controlling hyperglycemia remain the pillars for the prevention of diabetic nephropathy. However, evidence from multiple studies suggests that controlling DKD is more challenging. [jrenhep.com]
Both type I and type II diabetes prevent the body from turning sugar into energy. Normally, eating sugar causes an organ called the pancreas to release the hormone insulin. This insulin turns the sugar into energy. [unckidneycenter.org]
Prevention Edit Low protein diet helps in preventing or delaying the onset of kidney disease. High blood pressure requires proper treatment as continued high blood pressure accelerates the onset of kidney disease. [diabetes.wikia.com]