Diabetic nephropathy (DN) is well recognized by the glomerular basement thickening (GBM), mesangial matrix expansion and formation of nodules in the mesangium – the classic Kimmelsteil Wilson lesions. The very sight of these lesions makes a pathologist confirm…
A glomerular nodule, i.e. an acellular hyaline structure, can have varied etiologies. Most commonly we see it in the setting of diabetic nephropathy (DN). In these cases, it posesses all the associated features of DN on light microscopy…
Hypertension in diabetic patients increases the risk of microvascular and macrovascular complications. It is quantitatively and qualitatively different from the non-diabetic population and characterized by disturbed circadian rhythm of blood pressure (BP) with increased variability. It also features…
Over at eAJKD, Swapnil Hiremath has a nice post about the potential for SGLT-2 inhibitors to prevent diabetic nephropathy based on a review article published on the topic in AJKD. Essentially the theory is that increased serum glucose…
The next Nephrology Twitter Journal Club (@NephJC) will discuss a study in JASN describing the use of Atrasentan, a selective Endothelin-A receptor blocker, in diabetic kidney disease. This is the latest attempt to resurrect this class of agents…
In my experience the appetite to biopsy patients with clinical renal disease varies widely between clinician, institution and country. This is most apparent when it comes to the diabetic patient with renal disease. In my opinion there is…
Cystatin C has been proposed as an alternative marker of kidney function and studies have shown that CyC is a better predictor of mortality that serum creatinine. Although, when first introduced, it was thought that CyC was not…
The excellent drug development blog “In the pipeline” highlighted a fascinating phase 2 trial that is ongoing at the moment. Pentoxifylline is a methylxanthine phsophodiesterase inhibitor that has been used to treat peripheral vascular disease. It is also…
Sometimes when something appears too good to be true, it is too good to be true. Last year, a paper was published in the NEJM reporting a preliminary study of bardoxolone for the treatment of diabetic nephropathy. At…
Efforts aimed at lowering homocysteine levels in order to prevent the progression of CKD and cardiovascular disease takes another major hit in the April 28 issue of JAMA. High dose B-vitamin therapy has been shown to lower the…
