Diabetes in kidney

Diabetic kidney  effectz
 glomerulus
( nephrotic or non nephrotic range prtnuria or crf)
 tubules effected
 papillary necrosis  n pyelonephritis as arteries r hyalinised


Earliest symptm microalbumnuria (30 300mg per 24 hr)
 earliest change even before PROTENURIA occurs
Cap basmnt memb thickneng

 mc change
Diffuse mesangialsclerosis
 m characteristic
Nodular glomerularclerosis

 kimelsteil wilson are intecapillary glomerulosclersis
Ovoid or spherical
PAS postivs
Nodules of matrix
At perphery of glomerulus

 hyaline material in capillary loops
Fibrin caps
Capsular drops

 hyalinizatin of arterioles
AFFERENT n also
EFFERENT

 adaptationz
Gbm thickng
Glomerular hypertrophy
Increase gfr
Intial stages of diabetes

 uncontrolled diabetes
More glycosuria lead to
Glycogen accumlation in proxmal tubular cell
ARMANI EBSTEIN.cells

 in CRF cases broad waxy casts r seen