​Pathology - Diabetic nephropathy

​Pathology - Diabetic nephropathy
Related to chronic diabetes.
Type 1 diabetes has a 30%-40% risk of developing diabetic nephropathy after 20 years, while type 2 diabetes has a 15%-20% risk. However, due to the higher number of people with type 2 diabetes, End Stage Renal Disease (ESRD) is more common among them.

Men, African Americans, and Native Americans with diabetes are at an increased risk of developing diabetic nephropathy.

Pathology 
Light microscopy shows an increase in mesangial matrix, leading to either diffuse glomerulosclerosis (widespread increase in mesangial matrix) or nodular glomerulosclerosis (Kimmelstiel-Wilson nodules - nodular accumulations of mesangial matrix material).

Electron microscopy reveals a significant rise in glomerular basement membrane thickening.

Clinical Symptoms 
Nephrotic syndrome always coexists with diabetic retinopathy.
Laboratory results indicate microalbuminuria as an early symptom and proteinuria as a late indicator.
Implementing precise management of blood sugar levels; using ACE inhibitors to address hypertension and microalbuminuria in the initial phases to delay advancement.
Commonly leads to end-stage renal disease (ESRD) and necessitates dialysis.
Diabetic nephropathy is the primary cause of end-stage renal disease (ESRD) in the United States.