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Query: UMLS:C0011881 (
diabetic nephropathy
)
10,836
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Increased mesangial expansion is one of the most characteristic histological changes in
diabetic nephropathy
(DN). Although the pathogenesis of DN remains unclear, recent studies associate interleukin (IL) 6 with mesangial proliferative
glomerulonephritis
. To elucidate the expression and localization of IL-6 mRNA in renal tissues of patients with DN, a high-resolution in situ hybridization using digoxigenin-labeled oligonucleotide was performed. Patients were divided into three groups based on light microscopy findings: mild (group 1), moderate (group 2), and severe (group 3) mesangial expansion. The relationship between the expression of IL-6 mRNA and the degree of glomerular mesangial expansion in DN was examined. Individual cells positive for IL-6 mRNA were observed in glomeruli. These cells were mesangial cells, glomerular epithelial cells, and Bowman's capsule. The signal intensity was strongest in tissues from group 2 but was weak in those from groups 1 and 3. Most cells in the area of mesangial proliferation were strongly stained for IL-6 mRNA, and few positive cells were found in the Kimmelstiel-Wilson nodular lesion. In the interstitium, some tubules, particularly atrophic tubules, and some infiltrating cells were positively stained for IL-6 mRNA. The interstitial expression of IL-6 mRNA correlated significantly with the degree of interstitial injury and was remarkable in tissues from groups 2 and 3. We conclude that IL-6 mRNA is expressed by glomerular resident cells and interstitial cells in the renal tissue of patients with DN and that its expression may be associated with mesangial proliferation and may be involved in the tissue injury of DN.
...
PMID:In situ hybridization of interleukin 6 in diabetic nephropathy. 755 63
Advanced protein glycation has been proposed as a major factor in the development of
diabetic nephropathy
. Advanced glycation end products (AGEs) have altered the structure of extracellular matrix component and impaired self association in vitro. To elucidate the role of AGEs in the progression of
diabetic nephropathy
, the present study was undertaken to localize glomerular AGEs immunohistochemically. Ultrastructural changes of the mesangial matrix were analyzed with high resolution scanning electron microscopy. No glomerular AGEs staining was noted in normal control kidney specimens, or in tissue from
glomerulonephritis
patients without diabetes mellitus. The mesangium showed a positive AGEs staining in advanced stages of
diabetic nephropathy
, and the most characteristic finding was the strong AGEs staining in nodular lesions. By high resolution scanning electron microscopy, control and diabetic mesangial matrices revealed a meshwork structure composed of fine fibrils (10 nm in width) and numerous pores (12 to 13 nm in diameter). In the nodular lesions, however, loosening of the meshwork was significant, and the diameter of the pores was enlarged (approximately 24 nm). This study provides the first immunohistochemical evidence that AGEs are localized in diabetic glomeruli, most notably to nodular lesions. Advanced glycation might play a role in the progression of
diabetic nephropathy
through impairment of the assembly of matrix proteins in vivo.
...
PMID:Ultrastructure of nonenzymatically glycated mesangial matrix in diabetic nephropathy. 756 21
It was found that in Belgium, renal imaging techniques, demonstrating a decreased renal mass of both kidneys combined with either bumpy contours or papillary calcifications, were the only methods to reliably diagnose analgesic nephropathy (AN) in patients with end-stage renal failure. However, these criteria were selected in an area with a high prevalence of this disease (15.6% of the dialysis population at December 1990). To evaluate the criteria selected to diagnose AN in populations with lower or unknown prevalences of AN, the Analgesic Nephropathy Network of Europe (ANNE) was formed, consisting of 23 dialysis units from 14 European countries and Brazil. During 1991-1992, 598 new patients with equivocal diagnosis of renal disease (excluding biopsy-proven
glomerulonephritis
, polycystic disease,
diabetic nephropathy
and other systemic diseases) and who began renal replacement therapy in the ANNE centres were evaluated by a short questionnaire and two renal imaging techniques: sonography and either tomography or computed tomography (CT) scan. A comparison of 82 abusers (daily use of analgesic mixtures for at least 5 years) and 495 controls corroborated the excellent diagnostic performance of the renal imaging techniques for AN. We recommend the use of these renal imaging criteria in all patients without a clear renal diagnosis in order to obtain a more reliable insight into the magnitude of the AN problem in different countries.
...
PMID:Evaluation of diagnostic criteria for analgesic nephropathy in patients with end-stage renal failure: results of the ANNE study. Analgesic Nephropathy Network of Europe. 756 8
Adhesion molecules are important for immune regulatory mechanisms concerning antigen presentation, lymphocyte activation, localisation and migration as well as effector-target cell interactions in inflammatory processes. The immunohistochemical expression of ICAM-3, a recently cloned new member of the immunoglobulin family which also binds leucocyte function antigen 1 (LFA-1), was examined in 80 needle core biopsies from 35 renal allografts, 7 patients with mesangioproliferative
glomerulonephritis
, 5 patients with extracapillary
glomerulonephritis
, 4 patients with interstitial nephritis and 5 patients with
diabetic nephropathy
and 20 normal kidneys. In all types of lesions ICAM-3 was constitutively expressed on the majority of infiltrating leucocytes without detectable upregulation or presentation on possible target structures during inflammation indicating its possible role to be mainly in initiation of the inflammatory response.
...
PMID:Expression of the intercellular adhesion molecule-3 (ICAM-3) in human renal tissue with relation to kidney transplants and various inflammatory diseases. 757 78
The activity of an out-patient nephrology service during a period lasting from January 1991 to December 1993 (both inclusive) was studied. During this period, an average of 531 patients per million population and year were looked after, with a prevalence of 1,949 p.m.p. of chronic patients. Eleven point six per cent of the patients were discharged and 2.6% initiated treatment with hemodialysis, deducting nonappearances after examination, 66.9% of the patients were referred to permanent follow-up. Sixty seven point five per cent of the patients were older than 40 years and 31.2%, older than 60. The most frequent causes of consultation were AHT (17.4%), nephroangiosclerosis (5.7%), renal lithiasis (16.8%), idiopathic
glomerulonephritis
(10.9%) and
diabetic nephropathy
(8.2%). Fifty eight point five per cent of the patients were susceptible of out-patient care, especially those seen due to hypertension and lithiasis. We conclude that a significant increase in the needs of specialized care may be forecasted for the next years, mainly for arterial hypertension. Most of these needs could be covered through out-patient nephrology services.
...
PMID:[Clinical nephrological care not associated with substitutive treatment: the current situation and future needs for outpatient nephrology consultations]. 774 12
In a retrospective survey, we show that the incidence of end-stage renal disease (ESRD) is significantly raised among immigrant Indo-Asians referred to two UK renal units (p < 0.001). In addition to the expected increase in
diabetic nephropathy
,
glomerulonephritis
and chronic pyelonephritis are also seen more frequently in Indo-Asians. The most striking finding was a five-fold increase in ESRD of uncertain cause (p < 0.001) presenting with small smooth kidneys, which was strongly associated with active, mostly non-renal tuberculosis. The causes of this generalized increased susceptibility to renal disease are unknown. These findings have important implications both for primary health care screening and for planning the provision of renal replacement therapy.
...
PMID:High incidence of end-stage renal disease in Indo-Asians in the UK. 763 79
Tubular damage as suggested by enzymuria and tubular proteinuria is a recognized feature of
glomerulonephritis
(GN) with clinical proteinuria and both incipient and overt
diabetic nephropathy
(DN). However, little is known about the presence of tubulopathy in patients with primary GN, microalbuminuria [albumin excretion (AER) 30-300 mg/d] and microhematuria. Three groups were studied. The GN group comprised 17 (2 F) patients with biopsy-proven GN with microalbuminuria. The DN group comprised 35 (14 F) patients with incipient
diabetic nephropathy
with AER 30-300 mg/d, and controls comprised 38 (15 F) normal subjects with normal AER < 30 mg/d. Serum creatinine, albuminurinuria, transferrinuria, and markers of tubular damage such as urinary excretion of N-acetyl-glucosaminidase (NAG), leucine aminopeptidase (LAP), gamma-glutamyl transferase (gGT), and retinol binding protein (RBP) were measured. GN and DN had comparable degrees of albuminuria, transferrinuria, and LAP excretion, and these were significantly higher than controls. Serum creatinine was significantly higher in GN than DN and controls. DN had significantly higher NAG and RBP, and lower gGT than GN and controls. In both GN and DN groups, both glomerular proteins correlated with each other and NAG correlated significantly to LAP and gGT. Albuminuria correlated to tubular enzymuria in GN group but not in patients with DN. The results suggest that tubular damage is less marked in microalbuminuric patients with GN than those with DN despite similar degree of glomerular proteinuria. The pattern of tubulopathy is also different in the two groups, indicating differences in the pathogenesis of tubular damage in these two clinical settings.
...
PMID:Tubular damage in microalbuminuric patients with primary glomerulonephritis and diabetic nephropathy. 777 Jun 43
Formation of diabetic glomerulosclerosis was followed by the electron microscopy of 21 puncture renal biopsy and 12 incisive pancreatic biopsies from patients with insulin-dependent diabetes mellitus. The influence of the B-cell destruction and the decrease or absence of their activity (the presence of serum C-peptide) on the degree of renal damage and clinical symptoms of the
diabetic nephropathy
(proteinuria, hypertension) is noted. Dynamics of the diabetic glomerulosclerosis formation is as follows: 1st group--thickening of capillary basal membrane in the glomeruli, mesangial ectopy, formation of nodules at the periphery of loops; 2nd group--increase of the mesangial matrix, doubling of the glomerular capillary basal membrane, hyalin droplets in the capsule membrane. 4 stages in the development of diabetic glomerulopathy are distinguished: diabetic segmentary mesangioproliferative
glomerulonephritis
, mesangiolysis, two stages of glomerulosclerosis progression. Duration of the disease more than 15 years predetermines the development of diabetic glomerulosclerosis.
...
PMID:[Diabetic glomerulosclerosis--a prolonged stage of diabetic glomerulopathy]. 784 6
Transforming growth factor-beta (TGF-beta) is a cytokine that is important in embryogenesis, development, carcinogenesis, and tissue repair. TGF-beta is unique among cytokines in its widespread actions on the regulation of extracellular matrix. In a model of acute mesangial proliferative
glomerulonephritis
, it was shown that overproduction of TGF-beta is the cause of pathologic matrix accumulation in the nephritic glomeruli. TGF-beta acted to increase matrix production, inhibit matrix degradation, and modulate matrix receptors in the glomerulonephritic rats. Elevated expression of TGF-beta was also found in other experimental glomerular diseases, including
diabetic nephropathy
. Studies of humans with
glomerulonephritis
and
diabetic nephropathy
also strongly implicated TGF-beta in the pathogenesis of glomerular matrix build-up. Recently, the proteoglycan decorin was shown to neutralize TGF-beta. When injected into glomerulonephritic rats, decorin markedly suppressed pathologic matrix deposition in the glomeruli. Thus, decorin offers hope as a treatment for progressive kidney diseases caused by the overproduction of TGF-beta.
...
PMID:Transforming growth factor-beta and the pathogenesis of glomerular diseases. 785 Apr 12
Exposure to hydrocarbons has been implicated in the pathogenesis of
glomerulonephritis
but its role in the development of
diabetic nephropathy
remains unknown. Three groups of patients with Type 1 diabetes of over 10 years duration were studied. Group 1 comprised 45 patients (23 F) with no
diabetic nephropathy
(urinary albumin excretion (AER) < 30 mg 24 h-1), group 2 comprised 37 patients (17 F) with incipient
diabetic nephropathy
(AER between 30-300 mg 24 h-1), and group 3 comprised 31 patients (15 F) with overt
diabetic nephropathy
(AER > 300 mg 24 h-1). The groups were comparable for age, sex, duration of diabetes, recent glycaemic control, social class, and residential area. Patients were assessed blindly by a validated questionnaire and interview for hydrocarbon exposure, consumption of tobacco, analgesic agents, and alcohol. Exposure scores to hydrocarbons derived from the questionnaire were significantly higher in patients with incipient and overt
diabetic nephropathy
with smoking adjusted odds ratios of 3.6 and 5.2, respectively. The consumption of alcohol, analgesic agents, tobacco, and smoking habits were similar in the three groups. In conclusion, hydrocarbon exposure may be a key environmental factor in the development of
diabetic nephropathy
in patients with Type 1 diabetes.
...
PMID:Occupational hydrocarbon exposure and diabetic nephropathy. 785 Oct 74
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