title: Type 2 diabetic patients with diabetic retinopathy and concomitant microalbuminuria showed typical diabetic glomerulosclerosis and progressive renal dysfunction.
abstract: To determine whether or not diabetic retinopathy (DR) in type 2 diabetic patients can predict the renal functional decline.
  
  
  
  We examined 32 normo-microalbuminuric type 2 diabetic patients by renal biopsy (23 men, age 49±10yrs) divided into two groups according to the presence (n=19) or absence (n=13) of DR. Electron microscopic morphometry including mesangial fractional volume [Vv(Mes/glom)] were performed and light microscopic tissues were categorized as: C1, normal/near normal renal structure; C2, typical diabetic glomerulopathy; C3, atypical injury patterns. Patients were followed up for 7.1±3.8years, and glomerular filtration rate (GFR) and urinary albumin excretion (UAE) measurements were taken annually.
  
  
  
  Vv(Mes/glom) was larger in DR+ than that in DR-. Vv(Mes/glom) positively correlated with the UAE if patients had DR. The patients with DR had a significant higher rate of C2 pattern compared to those in DR-. Among patients with DR and C2, GFR in microalbuminuria (n=7) decreased while GFR in normoalbuminuria (n=5) did not change during the observation.
  
  
  
  Type 2 diabetic patients with DR and C2 showed progressive renal dysfunction after they had microalbuminuria. DR and albuminuria should be considered to determine renal function decline in type 2 diabetic patients.
authors.affiliation: Heath Care Center, Kitasato University, Kanagawa, Japan. Electronic address: moriy@kitasato-u.ac.jp.
authors.forename: Tatsumi
authors.initials: T
authors.lastname: Moriya
authors.affiliation: Heath Care Center, Kitasato University, Kanagawa, Japan.
authors.forename: Madoka
authors.initials: M
authors.lastname: Matsubara
authors.affiliation: Heath Care Center, Kitasato University, Kanagawa, Japan.
authors.forename: Eriko
authors.initials: E
authors.lastname: Kishihara
authors.affiliation: Heath Care Center, Kitasato University, Kanagawa, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Yoshida
authors.affiliation: Department of Pharmacology and Toxicology, Dokkyo Medical University School of Medicine, Tochigi, Japan.
authors.forename: Motoshi
authors.initials: M
authors.lastname: Ouchi
mesh_terms: D000328:Adult; D000419:Albuminuria / Q000503:physiopathology*; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D003928:Diabetic Nephropathies / Q000503:physiopathology*; D003930:Diabetic Retinopathy / Q000503:physiopathology*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007678:Kidney Glomerulus / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged
keywords: Diabetic glomerulosclerosis; Diabetic nephropathy; Diabetic retinopathy; Histological heterogeneity; Microalbuminuria; Renal function