title: Podocyte detachment in type 2 diabetic nephropathy.
abstract: BACKGROUND
  Glomerular podocyte number declines and urinary excretion of podocytes increases as kidney disease progresses in persons with type 2 diabetes mellitus (T2DM).
  
  
  METHODS
  Using high-power electron microscopy, we quantified podocyte detachment in T2DM.
  
  
  RESULTS
  We evaluated 106 glomeruli (range 1-6 per subject) from 40 Pima Indian subjects with T2DM enrolled in a clinical trial. On high-power electron micrographs, 35% of the subjects had no evidence of podocyte detachment. Among the remaining subjects, the median percentage of basement membrane with podocyte detachment was 0.62% (interquartile range = 0.32-1.52%).
  
  
  CONCLUSIONS
  Podocyte detachment from the glomerular basement membrane has been described and measured in type 1 diabetes mellitus using a different method. We now document podocyte detachment microscopically and quantify it morphometrically in humans with T2DM. The findings offer quantitative histologic support to a potential mechanism for the functional impairment, and possibly the sclerosis of glomeruli, in diabetic glomerular injury.
authors.affiliation: National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, AZ, USA.
authors.forename: E Jennifer
authors.initials: EJ
authors.lastname: Weil
authors.forename: Kevin V
authors.initials: KV
authors.lastname: Lemley
authors.forename: Berne
authors.initials: B
authors.lastname: Yee
authors.forename: Tracy
authors.initials: T
authors.lastname: Lovato
authors.forename: Meghan
authors.initials: M
authors.lastname: Richardson
authors.forename: Bryan D
authors.initials: BD
authors.lastname: Myers
authors.forename: Robert G
authors.initials: RG
authors.lastname: Nelson
mesh_terms: D000328:Adult; D001130:Arizona; D001485:Basement Membrane / Q000473:pathology* / Q000648:ultrastructure; D002448:Cell Adhesion; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000208:ethnology; D003928:Diabetic Nephropathies / Q000208:ethnology / Q000209:etiology / Q000473:pathology*; D005260:Female; D006652:Histological Techniques; D006801:Humans; D007198:Indians, North American; D008297:Male; D008854:Microscopy, Electron; D008875:Middle Aged; D050199:Podocytes / Q000473:pathology* / Q000648:ultrastructure