3-part #medicine #threadstorm series about diabetic nephropathy! This is sourced from an article I wrote here a few months ago.
Here’s part 2:
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3-part #medicine #threadstorm series about diabetic nephropathy! This is sourced from an article I wrote here a few months ago.
Here’s part 2:
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A drop of pathology and histology of diabetic nephropathy
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Source of the image Without getting into excessive detail…
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… the major pathologic findings from a biopsy of the kidney’s filtration system (the glomerulus) include 1) nodular mesangial expansion, thickened glomerular basement membrane, and arteriolar hyalinosis.
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In brief, the interaction of sugars with the matrix and fibers of the glomerulus cause the basement membrane and mesangium to become larger, and the arteriolar hyalinosis is a result of atherosclerosis due to hypertension…
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... and plaque buildup (which comes from chronic blood vessel damage). The mesangial nodules (also known as Kimmelsteil-Wilson nodules) develop when the mesangial expansion wraps around the tiny capillaries in the glomerulus.
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The severity of diabetic nephropathy can be determined through the biopsy, but it’s not practical, and generally not useful, to obtain a biopsy from every person who has chronic kidney disease.
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We usually determine the severity of disease by how effectively the glomerulus filters blood, a value known as glomerular filtration rate (GFR). It measures how much blood passes through the kidneys…
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... and it can be measured with a routine blood test which icidentally, also captures BUN an creatinine, two other markers of kidney function, as those are very commonly filtered products in the kidney.
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A fun little tip: in some cases of people without kidney disease, the BUN and creatinine values can be slightly heightened. An untrained eye can mistake those for developing or mild kidney disease, when in fact…
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... the person just happens to be dehydrated! When there’s less fluid being filtered through the blood, these products sometimes appear more concentrated in the blood, so their levels in the blood are higher.
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Drinking some water brings their concentrations back to normal.
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I know more than a few people with Diabetes, my mother is the closest one. My father's friend who has passed away a few years ago. My aunt (father's sister.)
It's intriguing how different diabetes manifests in different people. #blacklions