Global glomerular sclerosis and glomerular arteriolar hyalinosis in insulin dependent diabetes

Global glomerular sclerosis and glomerular arteriolar hyalinosis in insulin dependent diabetes. We studied the lesions of global glomerular sclerosis and arteriolar hyalinosis in 43 (29 females) insulin-dependent diabetes mellitus (IDDM) patients whose creatinine clearance (C Cr ) was ≥ 45ml/min/1.73m 2 and whose renal biopsies had at least 20 glomeruli available for study. These patients, ages 17 to 55 years, had IDDM for 7 to 32 (20 ± 6, X ± SD) years. C Cr ranged from 47 to 139 (91 ± 25)ml/min/1.73m 2 and urinary albumin excretion (UAE) from 5 to 3386 (median = 127) mg/24hrs. Eighteen patients were hypertensive. Thus, these patients represented a broad clinical range from normal renal function through overt diabetic nephropathy. The percent of glomeruli which were globally sclerosed was strongly correlated with C Cr (r = -0.64, P