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This Concept Map, created with IHMC CmapTools, has information related to: diabetic glomeruosclerosis, diabetic glomeruosclerosis e.g. Sx's Hx of HTN, diabetes diabetic retinopathy proteinuria edema BP poorly controlled serum creatinine 1.5mg/dl 4+ protein enlarged kidneys, diabetic glomeruosclerosis features #1 cause of 2ndary nephrotic syndrome in adults #1 cause of ESRD in U.S. usu occurs after 10-15yrs of diabetes diabetic retinopathy is associated with diabetic nephropathy 85-90% of time, diabetic glomeruosclerosis Tx strict BP control ACEI or ARB strict glucose control, diabetic glomeruosclerosis pathology Earliest changes are glomerular hypertrophy, mild mesangial matrix increase and thickened glomerular basement membranes, usually 2-8 years after onset of diabetes Diffuse thickening of GBM (6-10 x normal) = diffuse glomerulosclerosis Mesangial matrix increases from repetitive damage to mesangial cells producing Kimmelstiel-Wilson nodules. Not pathognomonic of diabetes! Hyaline changes in afferent and efferent arterioles. Pathognomonic of diabetes! Generalized tubular basement membrane thickening, diabetic glomeruosclerosis pathogenesis ????, Earliest changes are glomerular hypertrophy, mild mesangial matrix increase and thickened glomerular basement membranes, usually 2-8 years after onset of diabetes Diffuse thickening of GBM (6-10 x normal) = diffuse glomerulosclerosis Mesangial matrix increases from repetitive damage to mesangial cells producing Kimmelstiel-Wilson nodules. Not pathognomonic of diabetes! Hyaline changes in afferent and efferent arterioles. Pathognomonic of diabetes! Generalized tubular basement membrane thickening when only afferent aa involved (hyaline) HTN, Earliest changes are glomerular hypertrophy, mild mesangial matrix increase and thickened glomerular basement membranes, usually 2-8 years after onset of diabetes Diffuse thickening of GBM (6-10 x normal) = diffuse glomerulosclerosis Mesangial matrix increases from repetitive damage to mesangial cells producing Kimmelstiel-Wilson nodules. Not pathognomonic of diabetes! Hyaline changes in afferent and efferent arterioles. Pathognomonic of diabetes! Generalized tubular basement membrane thickening KW nodules nodular glomeruosclerosis, diabetic glomeruosclerosis def Sclerosis of glomeruli and associated nephrons secondary to thickened mesangial matrix and basement membrane in glomeruli and to arteriolar narrowing. The renal expression of generalized diabetic angiopathy.