ネフローゼ症候群を呈した糖尿病性腎症の臨床病理学的研究

Abstract

We determined the clinical and pathological characteristics of diabetic patients with nephrotic syndrome who underwent renal biopsy between January 1982 and December 1996. The subjects were 19 males and 7 females, aged 43 to 74 (mean 58) years. Mean duration of diabetes was 13.2 years. Urinary protein excretion was 3.5 - 26.4 (mean 7.5) g/day, serum total protein concentration 3.8 - 6.4 (mean 5.3) g/dl, serum albumin concentration 1.9 - 3.3 (mean 2.8) g/dl, serum creatinine concentration 0.6 - 3.0 (mean 1.4) mg/dl, and creatinine clearance 13 - 87 (mean 46) ml/min. Hypercholesterolemia was present in 54% of patients, and hypertension in 77%. Almost all of the patients had both diabetic retinopathy and neuropathy, whereas macroangiopathy was noted in only 4 patients. Advanced changes in diffuse and nodular glomerular lesions accompanied by vascular lesions were found in most of the patients. We conclude that diabetes with nephrotic syndrome is associated with advanced morphological changes in both glomerular and vascular lesions.