On the Diabetic Nephropathy

(1st Report) Clinical Symptoms and the Pathomorphological Findings of Diabetic Patients.

Abstract

Twenty cases of diabetic deaths were studied during 1951 to 1958 in the medical department of The First National Hospital of Tokyo. 1) The intercapillary glomerulosclerosis in the meaning of Kimmelstiel-Wilson were observed in 12 of our 20 cases. Grading of the lesions after Laipply as follows : one _??_ case, four _??_ cases, five _??_ cases and two + cases. 2) This nephropathy appeared clinically in the 3rd decade and more frequent in the 5 to 6 th decades. Males and females were affected equally. The diabetic nephropathy tends to appear in the long-term diabetics and is complicated by edema, increase in N.-P.N., and vascular lesions. Eight of anatomical proved Kimmel-stiel-Wilson casas were notically diabetic nephropathy. Juvenile diabetics and hypertensive cases showed higher percent-ages of retinitis. N.P.N. increase over one month duration showed poor prognosis. All of the nephrotic cases expired 3 to 4 years after the onset of albu minuria. In cases of improved albuminuria, however, infection, vascular lesions of heart or brain may cause death. Uremic deaths were observed in 8 cases. 8 of 20 cases not showed intercapillary glomernloscrelosis, of which 4cases were pancreatic carcinoma, only one of remaining 4 cases showed vascular lesion.