Urinary albumin as an indicator of diabetic nephropathy lesions in Japanese type 2 diabetic patients.
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.


CONCLUSIONS
(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.
Moriya
Tatsumi
T
Department of Pediatrics, University of Minnesota Medical School, Minneapolis 55455, USA.
Moriya
Rika
R
Yajima
Yoshitada
Y
Steffes
Michael W
MW
Mauer
Michael
M
D000328:Adult; D000419:Albuminuria / Q000473:pathology*; D044466:Asian People; D001485:Basement Membrane / Q000000981:diagnostic imaging / Q000473:pathology; D015415:Biomarkers; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000473:pathology*; D003928:Diabetic Nephropathies / Q000473:pathology*; D005260:Female; D006801:Humans; D007564:Japan; D007678:Kidney Glomerulus / Q000473:pathology / Q000648:ultrastructure; D008297:Male; D008854:Microscopy, Electron; D008875:Middle Aged; D014463:Ultrasonography
D015415:Biomarkers