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Evaluation of Diabetic Kidney Lesions

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Diabetic Kidney Disease

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Abstract

In 2014, the American Diabetes Society and the American Society of Nephrology proposed a new concept of diabetes-related kidney disease―diabetic kidney disease (DKD). The diagnosis of DKD was made by clinical findings, whereas the diagnosis of diabetic nephropathy(DN)—the previous main concept of diabetes-related kidney disease—was made by pathological evaluations. Accordingly, the patients’ characteristics between biopsy-proven DN cohort and DKD cohort are not identical.

The pathological findings of DN are diverse, especially in recent era. And it turned out that there are several pathological findings associated with worse renal outcomes, such as nodular lesions, mesangiolysis, interstitial changes, and the insudative lesions of the proximal tubules.

In general, there are two main reasons performing renal biopsy in DKD patients―for accurate diagnosis and for outcome prediction. In order to develop international consensus classification, the Renal Pathology Society proposed a new classification of type 1 and type 2 diabetic nephropathies in 2010, aiming easy to use internationally in clinical practice. Thereafter, the Japanese Renal Pathological Society (JRPS) proposed a new pathological classification in 2017, aiming to detect earlier pathological change of DN and unravel the complex mechanism of DN. Recent studies suggest utility of these classifications for prediction of their renal prognosis. The new pathological evaluations of DN may serve for accurate diagnosis, choice of the treatment, outcome prediction, and improving understanding of the mechanism of DN.

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Authors and Affiliations

  1. Nephrology Center, Toranomon Hospital, Tokyo, Japan

    Junichi Hoshino

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  1. Junichi Hoshino
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Correspondence to Junichi Hoshino .

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  1. Department of Nephrology and Laboratory, Kanazawa University, Kanazawa, Ishikawa, Japan

    Takashi Wada

  2. Department of Nephrology, Kanazawa Medical University, Kanazawa, Ishikawa, Japan

    Kengo Furuichi

  3. Department of Nephrology and Hypertension, Kawasaki Medical School, Kurashiki, Okayama, Japan

    Naoki Kashihara

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Hoshino, J. (2021). Evaluation of Diabetic Kidney Lesions. In: Wada, T., Furuichi, K., Kashihara, N. (eds) Diabetic Kidney Disease. Springer, Singapore. https://doi.org/10.1007/978-981-15-9301-7_10

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