Skip to main content
SpringerLink
Log in

Renal Ultrastructural Changes in Microalbuminuric IDDM-Patients

  • Chapter
Book cover The Kidney and Hypertension in Diabetes Mellitus

  • 104 Accesses

Abstract

Associations between early stages of diabetic nephropathy and structural changes is far from clarified. Some reports present rather marked changes in patients in the preclinical stage whereas others found very moderate changes in the early stage of nephropathy. Hence the issue is still a challenge to further studies. This chapter concentrates on the renal morphological changes in patients with insulin dependent diabetes mellitus (IDDM) and early nephropathy and the influence of blood glucose control on these structural changes. Associations between early stages of diabetic nephropathy and structural changes is far from clarified. Some reports present rather marked changes in patients in the preclinical stage whereas others found very moderate changes in the early stage of nephropathy. Hence the issue is still a challenge to further studies. This chapter concentrates on the renal morphological changes in patients with insulin dependent diabetes mellitus (IDDM) and early nephropathy and the influence of blood glucose control on these structural changes.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Østerby R (1993) Renal pathology in diabetes mellitus. Curr Opin Nephrol Hypertens 2:475–483

    Article  PubMed  Google Scholar 

  2. Hirose K, Østerby R, Nozawa M, Gundersen H J (1982) Development of glomerular lesions in experimental long-term diabetes in the rat. Kidney Int 21:889–895

    Article  Google Scholar 

  3. Gundersen HJ, Bendtsen TF, Korbo L, et al (1988) Some new, simple and efficient stereological methods and their use in pathological research and diagnosis. APMIS 96:379–394

    Article  PubMed  CAS  Google Scholar 

  4. Walker JD, Close CF, Jones SL, et al (1992) Glomerular structure in type-1 (insulin-dependent) diabetic patients with normo- and microalbuminuria. Kidney Int 41:741–748

    Article  PubMed  CAS  Google Scholar 

  5. Bangstad H-J, Østerby R, Dahl-Jørgensen K, et al (1993) Early glomerulopathy is present in young, type 1 (insulin-dependent) diabetic patients with microalbuminuria. Diabetologia 36:523–529

    Article  PubMed  CAS  Google Scholar 

  6. Østerby, R. Research methodologies related to renal complications: structural changes. In: Research Methodologies in Human Diabetes, vol.2. Diabetes Forum Series V, Part II, edited by Mogensen, C.E. and Standi, E. Berlin, New York: Walter de Gruyter & Co., 1995, p. 289–309.

    Google Scholar 

  7. Østerby R, Bangstad H-J, Nyberg G, Walker JD, Viberti GC (1995) A quantitative ultrastructural study of juxtaglomerular arterioles in IDDM patients with micro- and normoalbuminuria. Diabetologia 38:1320–1327

    Article  PubMed  Google Scholar 

  8. Bangstad H-J, Østerby R, Dahl-Jørgensen K, Berg KJ, Hartmann K, Hanssen KF (1994) Improvement of blood glucose control retards the progression of morphological changes in early diabetic nephropathy. Diabetologia 37:483–490

    Article  PubMed  CAS  Google Scholar 

  9. Rudberg S, Østerby R, Dahlquist G, Nyberg G, Persson B (1997) Predictors of renal morphological changes in the early stage of microalbuminuria in adolescents with IDDM. Diabetes Care 20:265–271

    Article  PubMed  CAS  Google Scholar 

  10. Østerby R, Bangstad H-J, Rudberg S (1998) Structural changes in microalbuminuria. Effect of intervention. Nephrol Dial Transplant, in press.

    Google Scholar 

  11. Fioretto P, Steffes MW, Mauer SM (1994) Glomerular structure in nonproteinuric IDDM patients with various levels of albuminuria. Diabetes 43:1358–1364

    Article  PubMed  CAS  Google Scholar 

  12. Østerby R (1974) Early phases in the development of diabetic glomerulopathy. Acta Med Scand Suppl 574:3–82

    PubMed  Google Scholar 

  13. Steffes MW, Sutherland DE, Goetz FC, Rich SS, Mauer SM (1985) Studies of kidney and muscle biopsy specimens from identical twins discordant for type I diabetes mellitus. N Engl J Med 312:1282–1287

    Article  PubMed  CAS  Google Scholar 

  14. Ellis EN, Warady BA, Wood EG, et al (1997) Renal structural-functional relationship in early diabetes mellitus. Pediatr Nephrol 11:584–591

    Article  PubMed  CAS  Google Scholar 

  15. Ziyadeh FN, Goldfarb S (1991) The renal tubulointerstitium in diabetes mellitus. Kidney Int 39:464–475

    Article  PubMed  CAS  Google Scholar 

  16. Lane PH, Steffes MW, Fioretto P, Mauer SM (1993) Renal interstitial expansion in insulin-dependent diabetes mellitus. Kidney Int 43:661–667

    Article  PubMed  CAS  Google Scholar 

  17. Rudberg S, Østerby R (1997) Decreasing glomerular filtration rate — an indicator of more advanced diabetic glomerulopathy in the early course of microalbuminuria in IDDM adolescents? Nephrol Dial Transplant 12:1282–1283

    Article  Google Scholar 

  18. Mauer SM, Brown DM, Matas AJ, Steffes MW (1978) Effects of pancreatic islet transplantation on the increased urinary albumin excretion rates in intact and uninephrectomized rats with diabetes mellitus. Diabetes 27:959–964

    Article  PubMed  CAS  Google Scholar 

  19. Rasch R (1979) Prevention of diabetic glomerulopathy in streptozotocin diabetic rats by insulin treatment Diabetologia 16:319–324

    CAS  Google Scholar 

  20. Rasch R (1979) Prevention of diabetic glomerulopathy in streptozotocin diabetic rats by insulin treatment. The mesangial regions. Diabetologia 17:243–248

    Article  PubMed  CAS  Google Scholar 

  21. Steifes MW, Brown DM, Basgen JM, Mauer SM (1980) Amelioration of mesangial volume and surface alterations following islet transplantation in diabetic rats. Diabetes 29:509–515

    Google Scholar 

  22. Orloff MJ, Yamanaka N, Greenleaf GE, Huang YT, Huang DG, Leng XS (1986) Reversal of mesangial enlargement in rats with long-standing diabetes by whole pancreas transplantation. Diabetes 35:347–354

    Article  PubMed  CAS  Google Scholar 

  23. Kern TS, Engerman RL (1987) Kidney morphology in experimental hyperglycemia. Diabetes 36:244–249

    Article  PubMed  CAS  Google Scholar 

  24. Barbosa J, Steffes MW, Sutherland DE, Connett JE, Rao KV, Mauer SM (1994) Effect of glycemic control on early diabetic renal lesions. A 5-year randomized controlled clinical trial of insulin-dependent diabetic kidney transplant recipients. JAMA 272:600–606

    Article  PubMed  CAS  Google Scholar 

  25. Wilczek HE, Jaremko G, Tyden G, Groth CG(1995) Evolution of diabetic nephropathy in kidney grafts. Evidence that a simultaneously transplanted pancreas exerts a protective effect. Transplantation 59:51–57

    Article  PubMed  CAS  Google Scholar 

  26. Nyberg G, Holdaas H, Brekke IB, et al (1996) Glomerular ultrastructure in kidneys transplanted simultaneously with a segmental pancreas to patients with type 1 diabetes. Nephrol Dial Transplant 11:1029–1033

    Article  PubMed  CAS  Google Scholar 

  27. Bilous RW, Mauer SM, Sutherland DE, Najarian JS, Goetz FC, Steffes MW (1989) The effects of pancreas transplantation on the glomerular structure of renal allografts in patients with insulin-dependent diabetes. N Engl J Med 321:80–85

    Article  PubMed  CAS  Google Scholar 

  28. Lane PH, Steffes MW, Mauer SM (1992) Glomerular structure in IDDM women with low glomerular filtration rate and normal urinary albumin excretion. Diabetes 41:581–586

    Article  PubMed  CAS  Google Scholar 

  29. Østerby R, Schmitz A, Nyberg G, Asplund J (1998) Renal structural changes in insulin dependent diabetic patients with albuminuria. Comparison of cases with onset of albuminuria after short or long duration. APMIS in press

    Google Scholar 

  30. Østerby R, Asplund J, Bangstad H-J, et al (1997) Glomerular volume and the glomerular vascular pole area in patients with insulin-dependent diabetes mellitus. Virch Arch 431:351–357

    Article  Google Scholar 

  31. Bangstad H-J, Østerby R, Hartmann A, Berg TJ, Dahl-Jørgensen K, Hanssen KF (1997) Renal morphological changes predict urinary albumin excretion rate 6 years later in patients with IDDM and microalbuminuria. Diabetologia 40:2085

    Google Scholar 

  32. Mogensen CE, Hansen KW, Østerby R, Damsgaard EM (1992) Blood pressure elevation versus abnormal albuminuria in the genesis and prediction of renal disease in diabetes. Diabetes Care 15:1192–1204

    Article  PubMed  CAS  Google Scholar 

  33. Poulsen PL, Hansen KW, Mogensen CE(1994) Ambulatory blood pressure in the transition from normo- to microalbuminuria. A longitudinal study in IDDM patients. Diabetes 43:1248–1253

    Article  PubMed  CAS  Google Scholar 

  34. Chavers BM, Bilous RW, Ellis EN, Steffes MW, Mauer SM (1989) Glomerular lesions and urinary albumin excretion in type I diabetes without overt proteinuria. N Engl J Med 320:966–970

    Article  PubMed  CAS  Google Scholar 

  35. Bangstad H J, Kofoed-Enevoldsen A, Dahl-Jørgensen K, Hanssen KF (1992) Glomerular charge selectivity and the influence of improved blood glucose control in type 1 (insulin-dependent) diabetic patients with microalbuminuria. Diabetologia 35:1165–1169

    Article  PubMed  CAS  Google Scholar 

  36. Silbiger S, Crowley S, Shan Z, Brownlee M, Satriano J, Schlondorff D (1993) Nonenzymatic glycation of mesangial matrix and prolonged exposure of mesangial matrix to elevated glucose reduces collagen synthesis and proteoglycan charge. Kidney Int 43:853–864

    Article  PubMed  CAS  Google Scholar 

  37. Brownlee M, Spiro RG(1979) Glomerular basement membrane metabolism in the diabetic rat. In vivo studies. Diabetes 28:121–125

    Article  CAS  Google Scholar 

  38. Roy S, Sala R, Cagliero E, Lorenzi M (1990) Overexpression of fibronectin induced by diabetes or high glucose: phenomenon with a memory. Proc Natl Acad Sci U S A 87:404–408

    Article  PubMed  CAS  Google Scholar 

  39. Cagliero E, Roth T, Roy S, Lorenzi M (1991) Characteristics and mechanisms of high-glucose-induced overexpression of basement membrane components in cultured human endothelial cells. Diabetes 40:102–110

    Article  PubMed  CAS  Google Scholar 

  40. Poulsom R, Kurkinen M, Prockop DJ, Boot Handford RP(1988) Increased steady-state levels of laminin B1 mRNA in kidneys of long-term streptozotocin-diabetic rats. No effect of an aldose reductase inhibitor. JBiol Chem 263:10072–10076

    CAS  Google Scholar 

  41. Ledbetter S, Copeland EJ, Noonan D, Vogeli G, Hasseil JR (1990) Altered steady-state mRNA levels of basement membrane proteins in diabetic mouse kidneys and thromboxane synthase inhibition. Diabetes 39:196–203

    Article  PubMed  CAS  Google Scholar 

  42. Ayo SH, Radnik RA, Garoni JA, Glass WF, Kreisberg JI (1990) High glucose causes an increase in extracellular matrix proteins in cultured mesangial cells. Am J Pathol 136:1339–1348

    PubMed  CAS  Google Scholar 

  43. Shimomura H, Spiro RG(1987) Studies on macromolecular components of human glomerular basement membrane and alterations in diabetes. Decreased levels of heparan sulfate proteoglycan and laminin. Diabetes 36:374–381

    Article  PubMed  CAS  Google Scholar 

  44. Olgemoller B, Schwaabe S, Gerbitz KD, Schleicher ED (1992) Elevated glucose decreases the content of a basement membrane associated heparan sulphate proteoglycan in proliferating cultured porcine mesangial cells. Diabetologia 35:183–186

    Article  PubMed  CAS  Google Scholar 

  45. Brownlee M, Vlassara H, Cerami A (1984) Nonenzymatic glycosylation and the pathogenesis of diabetic complications. Ann Intern Med 101:527–537

    Article  PubMed  CAS  Google Scholar 

  46. Berg TJ, Bangstad HJ, Torjesen PA, Østerby R, Bucala R, Hanssen KF(1997) Advanced glycation end products in serum predict changes in the kidney morphology of patients with insulin-dependent diabetes mellitus. Metabolism 46:661–665

    Article  PubMed  CAS  Google Scholar 

  47. Østerby R, Nyberg G (1987) New vessel formation in the renal corpuscles in advanced diabetic glomerulopathy. J Diabet Complications 1:122–127

    Article  PubMed  Google Scholar 

  48. Kashgarian M, Sterzel RB (1992) The pathobiology of the mesangium. Kidney Int 41:524–529

    Article  PubMed  CAS  Google Scholar 

  49. Hawkins NJ, Wakefield D, Charlesworth JA (1990) The role of mesangial cells in glomerular pathology. Pathology 22:24–32

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatrics, Aker Diabetes Research Centre, Aker University Hospital, Oslo, Norway

    Hans-Jacob Bangstad, Susanne Rudberg & Ruth Østerby

  2. Department of Woman and Child Health, Pediatric Unit, Karolinska Institute, Stockholm, Sweden

    Hans-Jacob Bangstad, Susanne Rudberg & Ruth Østerby

  3. Laboratory for Electron Microscopy, Aarhus Kommunehospital, Aarhus, Denmark

    Hans-Jacob Bangstad, Susanne Rudberg & Ruth Østerby

Authors
  1. Hans-Jacob Bangstad
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Susanne Rudberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ruth Østerby
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Medical Department M (Diabetes & Endocrinology), Aarhus Kommunehospital, Aarhus University Hospital, Aarhus C, Denmark

    Carl Erik Mogensen

Rights and permissions

Reprints and permissions

Copyright information

© 1998 Springer Science+Business Media Dordrecht

About this chapter

Cite this chapter

Bangstad, HJ., Rudberg, S., Østerby, R. (1998). Renal Ultrastructural Changes in Microalbuminuric IDDM-Patients. In: Mogensen, C.E. (eds) The Kidney and Hypertension in Diabetes Mellitus. Springer, Boston, MA. https://doi.org/10.1007/978-1-4757-6752-0_24

Download citation

  • DOI: https://doi.org/10.1007/978-1-4757-6752-0_24

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4757-6754-4

  • Online ISBN: 978-1-4757-6752-0

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation