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      Urinary Albumin as an Indicator of Diabetic Nephropathy Lesions in Japanese Type 2 Diabetic Patients

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          Caucasian type 2 diabetic patients with microalbuminuria (MA) or overt nephropathy (ON) show greater heterogeneity of renal lesions than type 1 diabetic patients. We examined whether a similar situation exists in 30 Japanese type 2 diabetic patients [21 male, age 48 ± (SD) 8 years, known duration 11 ± (SD) 8 years] without definable renal disease other than diabetic nephropathy. Six patients were normoalbuminuric (NA), 11 MA, and 13 had ON. Normal controls were 9 age-matched Japanese living-related renal transplant donors. Electron microscopic morphometry was performed on renal biopsy specimens and related to renal function. Glomerular basement membrane width and mesangial fractional volume [Vv(Mes/glom)] were increased in all type 2 diabetic patients groups (NA, MA, ON) as compared with normal controls. The Vv(Mes/glom) correlated directly with urinary albumin/creatinine. However, Vv(Mes/glom) as well as glomerular basement membrane width overlapped among the three functional categories (NA, MA, ON) and normal controls. In conclusion: (1) similar to Caucasian type 2 diabetic patients, Japanese type 2 diabetic patients have greater heterogeneity of renal structure than Caucasian type 1 diabetic patients, and (2) urinary albumin is not a reliable indicator of underlying renal structure in Japanese type 2 diabetic patients.

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          Author and article information

          S. Karger AG
          June 2002
          03 June 2002
          : 91
          : 2
          : 292-299
          Departments of aPediatrics and bLaboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, Minn., USA; cDepartment of Internal Medicine, Kitasato University School of Medicine, Sagamihara, Japan
          58407 Nephron 2002;91:292–299
          © 2002 S. Karger AG, Basel

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          Page count
          Figures: 2, Tables: 4, References: 35, Pages: 8
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          Original Paper

          Cardiovascular Medicine, Nephrology

          Renal lesions, Albuminuria, Diabetic nephropathy


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