Figure 1.

Characteristic glomerular changes and mechanisms of proteinuria in diabetic kidney disease. Characteristic glomerular changes in diabetic kidney disease (DKD) include glomerular basement membrane (GBM) thickening and mesangial expansion (due to increased mesangial matrix and increased mesangial cell size caused by hypertrophy). These changes are driven by hyperglycemia, and can ultimately lead to proteinuria if left unaddressed. Dashed arrows indicate mesangial expansion leading to glomerular hyperfiltration.