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      IgA Nephropathy Complicating Diabetic Glomerulosclerosis

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          A retrospective study was done on 66 diabetic patients who had renal biopsies performed during 1979–1994. This review shows 10 patients who presented IgA nephropathy associated with diabetic nephropathy. Six patients had insulin-dependent diabetes mellitus and 4 patients non-insulin-dependent diabetes mellitus. All patients presented with proteinuria and 7 had hematuria. Four patients presented with renal impairment. Histologic evaluation disclosed the presence of thickened glomerular basement membranes and increased mesangial matrix in all cases, associated with nodular sclerosis in 8 cases. By immunofluorescence, diffuse mesangial IgA deposits were observed in all cases. The high incidence of the coexistence of IgA nephropathy and diabetes seems not merely coincidental. Structural and/or functional abnormalities of the glomerular basement membranes might facilitate the development of immune complex glomerular diseases. In patients with diabetes, the appearance of urinary abnormalities and/or deterioration in renal function altered the clinical history of diabetic nephropathy. The disorders are clinically suggestive of the presence of nondiabetic renal disease and raised the possibility of another pathogenetic mechanism.

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          Idiopathic membranous glomerulonephritis in diabetic patients: report of three cases and review of the literature

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            Rapidly progressive glomerulonephritis superimposed on diabetic glomerulosclerosis. Recognition and treatment.

            Two patients with long-standing diabetes mellitus and diabetic retinopathy were evaluated for declining renal function and heavy albuminuria. Initially, diabetic glomerulosclerosis was suspected as the cause of progressive glomerulopathy. However, in both patients the rate of loss of glomerular filtration rate was greater than that usually seen in diabetic glomerulosclerosis, and the urine sediment contained many RBC casts. These findings led to renal biopsy, which demonstrated crescentic glomerulonephritis superimposed on diabetic glomerulopathy. Both patients were treated with prednisone and cyclophosphamide and both experienced substantial improvement in renal function. These experiences demonstrate the importance of searching for evidence of a superimposed treatable glomerulopathy in the diabetic patient with glomerulopathy and advancing renal insufficiency.
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              Acute glomerulonephritis complicating diabetic nephropathy

               J OLIVERO (1977)

                Author and article information

                S. Karger AG
                July 1998
                22 June 1998
                : 79
                : 3
                : 279-287
                a UPS EA-2405, et b Service de Néphrologie, CHU Rangueil, Toulouse, France
                45050 Nephron 1998;79:279–287
                © 1998 S. Karger AG, Basel

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                Page count
                Pages: 9
                Self URI (application/pdf):
                Original Paper

                Cardiovascular Medicine, Nephrology

                Immunoglobulin A nephropathy, Glomerulosclerosis, Diabetes


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