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Kimmelstiel wilson

Kameliya Bratoeva, George S Stoyanov, Albena Merdzhanova, Mariya Radanova
Introduction International studies show an increased incidence of chronic kidney disease (CKD) in patients with metabolic syndrome (MS). It is assumed that the major components of MS - obesity, insulin resistance, dyslipidemia, and hypertension - are linked to renal damage through the systemic release of several pro-inflammatory mediators, such as uric acid (UA), C-reactive protein (CRP), and generalized oxidative stress. The aim of the present study was to investigate the extent of kidney impairment and manifestations of dysfunction in rats with fructose-induced MS...
November 7, 2017: Curēus
Nao Nakamura, Kensei Taguchi, Yoshihiro Miyazono, Keiichiro Uemura, Kiyomi Koike, Yuka Kurokawa, Yosuke Nakayama, Yusuke Kaida, Ryo Shibata, Akihiro Tsuchimoto, Katsuhiko Asanuma, Kei Fukami
We report a case of smoking-related idiopathic nodular glomerulosclerosis (ING) with overexpression of glomerular advanced glycation end products (AGEs) and their receptor (RAGE). A 59-year-old Japanese man with nephrotic syndrome, who had a smoking history of one pack of cigarettes per day for approximately 40 years, presented with a 3-year history of urinalysis abnormalities without clinical evidence of diabetic mellitus. The patient's leg edema progressively worsened over the previous 2 years, and he was admitted to our hospital...
May 2018: CEN Case Reports
Olga Balafa, Georgios Liapis
Nodular glomerulosclerosis -as it was originally described by Kimmelstiel and Wilson- is the main pathognomonic lesion of diabetic nephropathy. However, this particular pattern can also be seen in other conditions such as membranoproliferative glomerulonephritis, light or heavy chain deposition disease, amyloidosis, fibrillary and immunotactoid glomerulonephritis and Takayasu's arteritis. History of diabetes as well as other clinical and pathological features are of crucial importance in order to determine the precise cause of nodular glomerulosclerosis...
November 10, 2017: Minerva Medica
Olga Balafa, Georgios Liapis, Paraskevi Pavlakou, Georgios Baltatzis, Rigas Kalaitzidis, Moses Elisaf
Kimmelstiel and Wilson originally described nodular glomerulosclerosis as the pathognomonic lesion of diabetic nephropathy. Nevertheless, nodular glomerulosclerosis pattern can rarely occur in non-diabetic patients. In such cases, the differential diagnosis includes membranoproliferative glomerulonephritis, light or heavy chain deposition disease, amyloidosis, fibrillary and immunotactoid glomerulonephritis and chronic hypoxic or ischemic conditions. In cases that the above entities cannot be proven, the term idiopathic nodular glomerulosclerosis is given...
December 2016: Pathology, Research and Practice
A D Lalayiannis, C Thompson, R Malcomson, D V Milford
BACKGROUND: Nodular glomerulosclerosis is seen in insulin dependent diabetic patients with nephropathy. Kimmelstiel-Wilson nodules on biopsy are considered pathognomonic. Diabetic nephropathy is a spectrum of glomerular and tubular disease which correlates with the duration of the diabetes and the extent of glycaemic control. CASE REPORT: An eleven year old girl with cystic fibrosis was referred with persistent heavy proteinuria. She underwent a renal biopsy which revealed nodular glomerulosclerosis with Kimmelstiel-Wilson-like nodules...
2016: Respiratory Medicine Case Reports
Francesca Conserva, Loreto Gesualdo, Massimo Papale
Diabetic nephropathy (DN), a microvascular complication occurring in approximately 20-40% of patients with type 2 diabetes mellitus (T2DM), is characterized by the progressive impairment of glomerular filtration and the development of Kimmelstiel-Wilson lesions leading to end-stage renal failure (ESRD). The causes and molecular mechanisms mediating the onset of T2DM chronic complications are yet sketchy and it is not clear why disease progression occurs only in some patients. We performed a systematic analysis of the most relevant studies investigating genetic susceptibility and specific transcriptomic, epigenetic, proteomic, and metabolomic patterns in order to summarize the most significant traits associated with the disease onset and progression...
2016: Journal of Diabetes Research
C Hu, L Sun, L Xiao, Y Han, X Fu, X Xiong, X Xu, Y Liu, S Yang, F Liu, Y S Kanwar
Diabetic Nephropathy (DN) is believed to be a major microvascular complication of diabetes. The hallmark of DN includes deposition of Extracellular Matrix (ECM) proteins, such as, collagen, laminin and fibronectin in the mesangium and renal tubulo-interstitium of the glomerulus and basement membranes. Such an increased expression of ECM leads to glomerular and tubular basement membranes thickening and increase of mesangial matrix, ultimately resulting in glomerulosclerosis and tubulointerstitial fibrosis. The characteristic morphologic glomerular mesangial lesion has been described as Kimmelstiel-Wilson nodule, and the process at times is referred to as diabetic nodular glomerulosclerosis...
2015: Current Medicinal Chemistry
Pardeep K Aggarwal, Delma Veron, David B Thomas, Dionicio Siegel, Gilbert Moeckel, Michael Kashgarian, Alda Tufro
The onset of diabetic nephropathy (DN) is highlighted by glomerular filtration barrier abnormalities. Identifying pathogenic factors and targetable pathways driving DN is crucial to developing novel therapies and improving the disease outcome. Semaphorin3a (sema3a) is a guidance protein secreted by podocytes. Excess sema3a disrupts the glomerular filtration barrier. Here, using immunohistochemistry, we show increased podocyte SEMA3A in renal biopsies from patients with advanced DN. Using inducible, podocyte-specific Sema3a gain-of-function (Sema3a(+)) mice made diabetic with streptozotocin, we demonstrate that sema3a is pathogenic in DN...
May 2015: Diabetes
D Lizicarova, B Krahulec, E Hirnerova, L Gaspar, Z Celecova
Diabetic nephropathy is becoming an increasingly important cause of morbidity and mortality worldwide as a consequence of increasing prevalence of type 2 diabetes and obesity. The glomeruli of patients with diabetes are characterized by glomerular hypertrophy, widening of the glomerular basement membrane, mesangial expansion, podocytopenia leading to nodular (Kimmelstiel-Wilson) glomerulosclerosis. Many studies have reported the initiation and progression of incipient nephropathy in type 1 diabetes patients, but only limited data are available in type 2 diabetes patients...
2014: Bratislavské Lekárske Listy
Ahmed H Abdelhafiz, Meguid El Nahas, Jose M F de Oliveira
As the population ages and diabetes mellitus increases in prevalence, the incidence of diabetic nephropathy (DN) is becoming a disease of older people (aged ≥ 75 years). As the epidemiology of diabetes mellitus and DN shifts toward this patient population, the pathogenesis of DN in old age is changing: the pathologic findings suggest ischemia and hypertension, and the classic Kimmelstiel-Wilson lesions may be absent. The demographic shift in the epidemiology and the associated changes in pathology because of aging and atherosclerosis will have a significant impact on various aspects related to the disease in old age...
July 2014: Postgraduate Medicine
Satoshi Hara, Kazuhiro Umeyama, Takashi Yokoo, Hiroshi Nagashima, Michio Nagata
Glomerular nodular lesions, known as Kimmelstiel-Wilson nodules, are a pathological hallmark of progressive human diabetic nephropathy. We have induced severe diabetes in pigs carrying a dominant-negative mutant hepatocyte nuclear factor 1-alpha (HNF1α) P291fsinsC, a maturity-onset diabetes of the young type-3 (MODY3) gene in humans. In this model, glomerular pathology revealed that formation of diffuse glomerular nodules commenced as young as 1 month of age and increased in size and incidence until the age of 10 months, the end of the study period...
2014: PloS One
Delma Veron, Pardeep K Aggarwal, Heino Velazquez, Michael Kashgarian, Gilbert Moeckel, Alda Tufro
VEGF-A and nitric oxide are essential for glomerular filtration barrier homeostasis and are dysregulated in diabetic nephropathy. Here, we examined the effect of excess podocyte VEGF-A on the renal phenotype of endothelial nitric oxide synthase (eNOS) knockout mice. Podocyte-specific VEGF(164) gain of function in eNOS(-/-) mice resulted in nodular glomerulosclerosis, mesangiolysis, microaneurysms, and arteriolar hyalinosis associated with massive proteinuria and renal failure in the absence of diabetic milieu or hypertension...
August 2014: Journal of the American Society of Nephrology: JASN
H U Funk
The pancreatic capillaries of 25 diabetics with Kimmelstiel-Wilson glomerulosclerosis and 54 without, were examined for PAS-positive homogeneous thickening of the wall. 70 nondiabetic patients were used as controls. The average age of each of the 3 groups was close to 70 years. Homogeneous capillary lesions were found in approximately 1/3 of the cases with glomerulosclerosis, in 1/7 of those without glomerulosclerosis, and not at all in nondiabetics. The homogeneous lesion is mainly situated in the extrainsular capillaries...
April 1966: Diabetologia
Kirtee Raparia, Irtaza Usman, Yashpal S Kanwar
CONTEXT: Nodular, intercapillary glomerulosclerotic lesions resembling Kimmelstiel-Wilson nodules commonly observed in diabetic nephropathy can also be seen in patients without any clinical history or evidence of diabetes. OBJECTIVES: To discuss the pathobiology of lesions reminiscent of diabetes nephropathy, including light-chain deposition disease, amyloidosis, immunotactoid nephropathy, the membranoproliferative form of glomerulonephritis, and idiopathic nodular glomerulosclerosis, and how to differentiate them from diabetic nephropathy...
March 2013: Archives of Pathology & Laboratory Medicine
Richárd Halmai, Péter Degrell, István András Szijártó, Viktória Mátyás, Gergå Attila Molnár, Tibor Kovács, István Wittmann
BACKGROUND: The histological pattern of nodular glomerulosclerosis (NGS) can be found both in diabetic nephropathy (Kimmelstiel-Wilson (KW) lesion) and non-diabetic nodular glomerulosclerosis (non-diab NGS). Chronic smoking is considered to be a potential cause of non-diab NGS, but the prevalence of smokers in KW is unknown. METHODS: In a retrospective analysis, native renal biopsy specimens (n = 644, 2001 - 2011) were evaluated and male patients' characteristics, including smoking habits, were assessed within three groups: diabetic patients with KW (n = 15), diabetic patients with other classes of diabetic nephropathy (non-KW; n = 46), and patients with non-diab NGS (n = 7)...
July 2013: Clinical Nephrology
Yoshie Sasatomi, Kenji Ito, Yasuhiro Abe, Katsuhisa Miyake, Satoru Ogahara, Hitoshi Nakashima, Takao Saito
BACKGROUND: Anemia in patients with early diabetes mellitus nephrosclerosis (DMN) is more severe than in patients with kidney disease of other origins, and the mechanism for this remains unclear. In this study, we carried out a retrospective study in order to identify the factors associated with anemia in patients with DMN. METHODS: To elucidate the factors that influence the severity of anemia in patients with DMN, we carried out a retrospective follow-up study of 124 biopsy-proven DMN cases [mean (SE) age, 55...
2012: Renal Failure
A Falcão Pedrosa Costa, W Albert Gomes dos Santos, M A Gonçalves Pontes Filho, F Teles Farias, V Modesto dos Santos
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. Histological features of idiopathic nodular glomerulosclerosis are similar to the Kimmelstiel-Wilson changes. Recent evidence points to the role of hyperglycemia, hyperlipidemia, hypertension and smoking in the mechanisms of this uncommon condition. The case study of a 65-year-old male presenting recent arterial hypertension and nodular non-diabetic glomerulosclerosis is described, and the possible role of heavy smoking in the pathogenesis of this condition is emphasized...
May 2011: Anales del Sistema Sanitario de Navarra
Chiharu Kinoshita, Yoshimoto Inoue, Yoko Kanda, Chiaki Kanda
We report a case of idiopathic nodular glomerulosclerosis (ING) mimicking diabetic Kimmelstiel-Wilson glomerulopathy. A 72-year-old man suffering from nephritic syndrome and renal dysfunction had no prior history of diabetes mellitus, but had impaired glucose tolerance and a history of hypertension and smoking. A kidney biopsy showed increased mesangial matrix with Kimmelstiel-Wilson-like nodules, glomerular basement membrane thickening and capillary microaneurysms. Additionally, a large amount of fibrin caps detectable as electron-dense subendothelial material by electron microscopy were observed...
December 2011: Clinical and Experimental Nephrology
D Veron, C A Bertuccio, A Marlier, K Reidy, A M Garcia, J Jimenez, H Velazquez, M Kashgarian, G W Moeckel, A Tufro
AIMS/HYPOTHESIS: The pathogenic role of excessive vascular endothelial growth factor (VEGF)-A in diabetic nephropathy has not been defined. We sought to test whether increased podocyte VEGF-A signalling determines the severity of diabetic glomerulopathy. METHODS: Podocyte-specific, doxycycline-inducible Vegf₁₆₄ (the most abundant Vegfa isoform) overexpressing adult transgenic mice were made diabetic with low doses of streptozotocin and examined 12 weeks after onset of diabetes...
May 2011: Diabetologia
Tomohiro Kikuta, Tsutomu Inoue, Yusuke Watanabe, Takahiko Sato, Masahiro Tsudai, Kousuke Uchida, Keita Sueyoshi, Eriko Kojima, Takaki Sakurai, Hirokazu Okada, Tsuneo Takenaka, Hiromichi Suzuki
Diabetic nodular glomerulosclerosis, also known as Kimmelstiel-Wilson syndrome, is a specific pathological variant of diabetic nephropathy ; however, histological findings similar to diabetic nephropathy are observed occasionally without glucose intolerance. Therefore, such nodular glomerulosclerosis is called idiopathic nodular glomerulosclerosis. Several case reports that have been published recently indicate that smoking and hypertension, which are classical renal risk factors, may be attributed to this form of glomerular degeneration...
2010: Nihon Jinzo Gakkai Shi
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