Table 1.
Pathologic parameter scoring of kidney biopsy specimens from 109 patients with biopsy-proven diabetic glomerulosclerosis between 1995 and 2011
| Pathologic Parameters and Scores | Pathologic Scoring Definitions | Prevalence, n (%) |
|---|---|---|
| RPS DKD classa | ||
| I | Mild, nonspecific LM changes with GBM thickening | 0 (0.0) |
| IIa | Mild mesangial expansion in >25% of mesangium | 6 (5.5) |
| IIb | Severe mesangial expansion in >25% of mesangium | 30 (27.5) |
| III | At least one KW nodule | 56 (51.4) |
| IV | Advanced diabetic glomerulosclerosis | 17 (15.6) |
| Mild mesangial expansionb | ||
| 0 | None | 89 (81.7) |
| 1 | 1%–25% | 3 (2.8) |
| 2 | 26%–50% | 8 (7.3) |
| 3 | 51%–75% | 5 (4.6) |
| 4 | >75% | 4 (3.7) |
| Severe mesangial expansion | ||
| 0 | None | 15 (13.8) |
| 1 | 1%–25% | 5 (4.6) |
| 2 | 26%–50% | 24 (22.0) |
| 3 | 51%–75% | 39 (35.8) |
| 4 | >75% | 26 (23.9) |
| Global glomerulosclerosis | ||
| 0 | None | 6 (5.5) |
| 1 | 1%–25% | 47 (43.1) |
| 2 | 26%–50% | 38 (34.9) |
| 3 | 51%–75% | 15 (13.8) |
| 4 | >75% | 3 (2.8) |
| Presence of KW nodules | ||
| 0 | None | 44 (40.4) |
| 1 | 1%–25% | 24 (22.0) |
| 2 | 26%–50% | 23 (21.1) |
| 3 | 51%–75% | 12 (11.0) |
| 4 | >75% | 6 (5.5) |
| SS | ||
| 0 | None | 17 (15.6) |
| 1 | 1%–25% | 43 (39.5) |
| 2 | 26%–50% | 41 (37.6) |
| 3 | 51%–75% | 8 (7.3) |
| 4 | >75% | 0 (0.0) |
| Mesangiolysis | ||
| 0 | None | 30 (27.5) |
| 1 | 1%–25% | 28 (25.7) |
| 2 | 26%–50% | 36 (33.0) |
| 3 | 50%–75% | 15 (13.8) |
| 4 | >75% | 0 (0.00) |
| Glomerular hyalinosis | ||
| 0 | None | 75 (68.8) |
| 1 | Present | 34 (31.2) |
| EXHC | ||
| 0 | None | 93 (85.3) |
| 1 | 1%–25% | 14 (12.8) |
| 2 | 26%–50% | 2 (1.8) |
| 3 | >50% | 0 (0.0) |
| Arteriolosclerosis | ||
| 0 | None | 0 (0.0) |
| 1 | No thickening of wall | 15 (13.8) |
| 2 | Thickened wall with patent lumen | 45 (41.3) |
| 3 | Severely or completely narrowed lumen | 49 (45.0) |
| Arteriosclerosis | ||
| 0 | None | 4 (3.7) |
| 1 | Intimal fibrosis <25% media thickness | 15 (13.8) |
| 2 | Intimal fibrosis 25%–49% media thickness | 45 (41.3) |
| 3 | Intimal fibrosis ≥50% media thickness | 40 (36.7) |
| Missing | No arteries sampled | 5 (4.6) |
| Interstitial fibrosis | ||
| 0 | None | 2 (1.8) |
| 1 | 1%–25% cortex | 18 (16.5) |
| 2 | 26%–50% cortex | 43 (39.5) |
| 3 | 51%–75% cortex | 46 (42.2) |
| 4 | >75% cortex | 0 (0.00) |
| Interstitial inflammation | ||
| 0 | None | 10 (9.2) |
| 1 | <25% of interstitial fibrotic regions | 94 (86.2) |
| 2 | ≥25% of interstitial fibrotic regions | 5 (4.6) |
For analyses, scores of 3 and 4 were collapsed together as 3 for mild mesangial expansion, severe mesangial expansion, global glomerulosclerosis, KW nodules, SS, and mesangiolysis. Scores of 0 and 1 were collapsed together for interstitial fibrosis. LM, light microscopy; GBM, glomerular basement membrane; KW, Kimmelstiel–Wilson.
a
Scores as defined by the RPS Diabetic Nephropathy Classification.
b
Glomerular lesions were scored as % of glomeruli.