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Diabetic Nephropathy 1

Diabetic nephropathy


Vignette: A 60-year-old man presents to the clinic for a routine check-up. His medical history is significant for hypertension and type 2 diabetes mellitus, both well controlled with medication. He has a 30-pack-year history of smoking but quit 10 years ago. His physical examination is unremarkable. However, his recent lab results show increased serum creatinine and blood urea nitrogen levels. Urinalysis reveals proteinuria and microscopic hematuria. A renal biopsy is performed and shows thickening and hardening of the glomerular basement membrane with nodular glomerulosclerosis.

Question: What is the most likely diagnosis?


A) IgA nephropathy

B) Minimal change disease

C) Membranous nephropathy

D) Diabetic nephropathy

E) Focal segmental glomerulosclerosis


D) Diabetic nephropathy


The patient's longstanding history of type 2 diabetes mellitus, along with the presence of proteinuria, microscopic hematuria, and elevated serum creatinine and blood urea nitrogen levels, suggest kidney damage. The biopsy findings of nodular glomerulosclerosis and thickening and hardening of the glomerular basement membrane are classic for diabetic nephropathy. diabetic nephropathy is a common complication of diabetes and is a leading cause of end-stage renal disease. Early changes include glomerular hyperfiltration and microalbuminuria. As the disease progresses, persistent albuminuria, elevated blood pressure, and a gradual decline in glomerular filtration rate occur.


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