Abstract
Clinicopathological investigations were made about the mode of the onset and progress of diabetic glomerulosclerosis; 206 renal biopsies were done on randomly selected 191 patients with various degrees of diabetic states. On 11 diabetics from whom renal biopsy specimens sufficient for histological examination could be obtained twice or three times, a prospective study was carried out by correlating morphological with clinical features during the periods of biopsies. The onset of diabetic glomerulosclerosis was not parallel with the progress; juvenile diabetics usually showed a lower incidence of diabetic glomerulosclerosis than adult-onset diabetics, whereas the progress of the disease was slower in adult-onset diabetics than in juvenile ones in whom diabetic renal changes strikingly increased along with prolongation of diabetes. Diabetic glomerulosclerosis, at least in overt diabetes, is essentially irreversible in its nature, and the histological changes are closely correlated not only with blood sugar, but also with serum lipids and blood pressure levels. More or less remarkable discrepancy between the grade of morphological changes and clinical features is recognized, when the renal lesions are not so advanced, The prognosis of diabetic glomerulosclerosis depends necessarily on both clinical and morphological aspects, and repeated renal biopsies may serve to offer valuable information from the histopathological point.
