Renal pathology patterns in type II diabetes mellitus: relationship with retinopathy

had glomerular changes characteristic of the diabetic state including enlarged glomeruli and an increase in Background. The glomerular and retinal vessels are both aVected in patients with type I and type II mesangial matrix without Kimmelstiel‐Wilson nodules (mesangial sclerosis lesion); and two had other primary diabetes mellitus. However, the prevalence of the nodular form of diabetic glomerular sclerosis glomerular diseases (IgA and membranous nephropathy). Patients with Kimmelstiel‐Wilson nodules ( Kimmelstiel‐Wilson lesion) and other forms of glomerular pathology including diVuse mesangial sclerosis had elevated serum creatinines compared to patients with mesangial sclerosis lesions, but there were no and their clinical correlates in type II diabetes are less well known. In addition, although recent studies have other significant diVerences. Patients with Kimmelstiel‐ Wilson nodules had more severe overall retinopathy suggested that non-diabetic glomerular disease was a common cause of proteinuria in type II diabetes, the than those with mesangial sclerosis lesions (P=0.0043): six of seven with proliferative retinopathy had prevalence of other diseases is unknown. The literature on this subject is clouded by clinical bias regarding Kimmelstiel‐Wilson nodules, and seven of the eight patients without retinopathy had mesangial sclerosis patients with diabetes who undergo renal biopsy. Methods. Glomerular and retinal pathology and clin- lesions. Conclusions. The two discrete patterns of glomerular ical correlates were studied in 36 patients enrolled in a prospective clinical trial of patients with type II pathology and the correlation between diabetic retinopathy and the Kimmelstiel‐Wilson lesion but not diabetes mellitus, proteinuria, renal insuYciency, and hypertension. the mesangial sclerosis lesion suggest that the Kimmelstiel‐Wilson and mesangial sclerosis lesions of