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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Diabetologia 15 (1978), S. 361-363 
    ISSN: 1432-0428
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-0428
    Keywords: Experimental diabetes ; basement membrane mass ; kidney hypertrophy ; glomerular hypertrophy ; glomerular capillaries ; filtration surface ; capillary morphology ; stereology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Renal glomerular structures have been studied during the initial phases of renal and glomerular hypertrophy in streptozotocin diabetic rats. — After four days of diabetes significant increases were found in the following absolute structural quantities: the tuft volume (25%), the surface area (42%) and volume (46%) of peripheral basement membrane, and capillary luminal volume (29%). No further changes in these quantities took place over the succeeding 47 days. The geometry of the capillaries, however, changed over this period: at 4 days the total capillary length had increased significantly (32%) with an unchanged average cross sectional area, whereas at 47 days the length had reverted to normal, but average cross sectional area had increased (30%). The increased surface of filtering area may be the morphological counterpart of increased glomerular filtration rate. The changes in glomerular volume were thus accompanied by changes in glomerular structural composition which after a few weeks returned to normal, in balance with the increased volume.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-0428
    Keywords: Growth hormone ; diabetic microangiopathy ; basement membrane thickening ; experimental diabetes ; glomerular basement membrane
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Injection of porcine growth hormone (200 μg) or saline 5 days a week for 16 to 20 weeks in streptozotocin-diabetic rats showed that compared to saline growth hormone produced a 2 1/2-fold larger increase in glomerular capillary basement membrane thickness (2p=0.027). The possible significance of this effect of an elevated level of growth hormone for diabetic microangiopathy is discussed.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Diabetologia 17 (1979), S. 71-76 
    ISSN: 1432-0428
    Keywords: Basement membrane ; diabetic nephropathy ; glomerular filtration rate ; glomerular hypertrophy ; glomerulus ; glucagon ; hypertension ; insulin ; kidney function ; proteinuria ; renal plasma flow
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Renal hyperfunction and hypertrophy are characteristic findings in the early diabetic state, both in diabetes mellitus and in experimental diabetes. A number of structure-function relationships and their likely mechanisms are discussed. The metabolically induced hypertrophy of glomerular capillaries possibly plays a central role. Its cause is not known, but recent results on its time-course emphasize the probable long-term consequences of the irreversibility of the accumulation of basement membrane material.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1432-0428
    Keywords: Diabetes ; growth hormone ; hypertrophy ; kidney ; rat ; streptozotocin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Normal and diabetic rats were given daily injections of human growth hormone for four days (5 mg per rat per day). Injected rats showed no differences from uninjected controls with respect to kidney weight or renal content of protein, RNA or DNA. Kidney weight increased by 7% after two days of diabetes and by 20% after four days, but growth hormone caused no augmentation of the hypertrophy. It is concluded that growth hormone plays no role in the initiation of diabetic renal hypertrophy.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Diabetologia 13 (1977), S. 43-48 
    ISSN: 1432-0428
    Keywords: Long-term diabetes ; diabetic glomerulosclerosis ; diabetic renal disease ; glomerular size ; compensatory glomerular hypertrophy ; kidney function
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A study of autopsy kidney material from six long-term diabetics and four controls was performed in order to elucidate the mechanism of the glomerular enlargement in long-term diabetics. The volume and the severity of the glomerular lesion were measured in each of a number of randomly selected, open glomeruli. The relative amount of solid material was taken as an expression of the severity of the glomerular lesion. In the long-term diabetics the volume of open glomeruli was almost doubled compared to that of controls and in the individual subject the enlargement was found to be inversely related to the relative amount of solid material in the glomeruli. This indicates that the enlargement of open glomeruli in long-term diabetics is due to a compensatory hypertrophy rather than to the excessive deposition of basement membrane material. The number of nuclei per open glomerulus was increased in long-term diabetics, but nuclear size was unchanged. Most of the long-term diabetics had a large number of occluded glomeruli, and the individual, relative number of such glomeruli correlated closely both with the duration of diabetes above 15 years and the concentration of creatinine in serum. It is concluded that the destruction of glomeruli due to diabetic microangiopathy is compensated for some years by hypertrophy of the least affected glomeruli. This compensatory hypertrophy of glomeruli might well account for the preservation of renal function in long-term diabetics for a number of years despite the progressive basement membrane lesions of diabetic microangiopathy.
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    Diabetologia 13 (1977), S. 207-210 
    ISSN: 1432-0428
    Keywords: Early diabetes ; glomerular hypertrophy ; capillary surface ; filtration surface ; basement membrane ; diabetic microangiopathy ; kidney hyperfunction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The present electron microscopic study shows that the kidney hyperfunction in early diabetes can be due to a significant morphological change: an increased glomerular filtration surface. Applying standard stereological methods, the area of the peripheral wall of the glomerular capillaries was measured in biopsy specimens obtained from 7 patients with early diabetes and 7 controls. — An 80 per cent enlargement of the capillary wall (the surface of the peripheral basement membrane) was found in the diabetics (2 p=0.0096). Also the total area of the interface between the tuft and the urinary space was increased by 70 per cent (2 p=0.029). Since the thickness of the peripheral basement membrane is known to be unchanged in patients with early diabetes the finding of an increased area of the membrane implies that an increased quantity of basement membrane material is present in these patients. The significance of this phenomenon for the understanding of the metabolism of the basement membrane is discussed, and a working hypothesis is advanced for the pathogenesis of the diabetic microangiopathy.
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    Diabetologia 9 (1973), S. 108-114 
    ISSN: 1432-0428
    Keywords: Diabetic glomerulosclerosis ; diabetic microangiopaty ; glomerular ultrastructure ; basement membrane ; quantitative stereology ; early diabetes ; kidney ; kidney biopsy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Glomerular basement membrane thickness has been estimated by quantitative electron-microscopic study in control subjects and in juvenile diabetics at onset and with short-term diabetes. — The juxta-mesangial part of the basement membrane as well as basement membranes located close to the vascular pole were considered separately and their thickness compared with the remainder of the basement membrane of the same cross section. — It was found that basement membrane, both close to mesangial regions and to the vascular pole, showed greater variation in thickness than the remainder of the glomerular basement membrane. The deviations were, however, small. — The initial thickening occurring in diabetic patients after a few years of the disease was shown to take place as a generalized phenomenon over the entire cross section and did not primarily affect the basement membrane close to mesangial regions or the vascular pole.
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 1432-0428
    Keywords: Kidney transplants ; diabetic glomerulopathy ; basement membrane thickness ; mesangial volume fraction ; interstitial fibrosis ; cyclosporine ; stereology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The development of diabetic glomerulopathy in kidneys transplanted to diabetic patients was estimated in transplant biopsies and evaluated in relation to suspected clinical risk factors for diabetic nephropathy. Surgical biopsies were taken at baseline and at 24–36 months post-transplantation in 16 Type 1 (insulin-dependent) diabetic patients and 8 non-diabetic control subjects with a glomerular filtration rate more than 30 ml·min− at follow-up. Immunosuppressive therapy included cyclosporine in all but one case. Stereological methods were used to assess basement membrane thickness, volume fraction of mesangium per glomerulus, and volume fraction of matrix per mesangium. The volume fraction of interstitial tissue per cortex was estimated by light microscopy. After 2 years the basement membrane thickness had increased by 55 nm (SD 58 nm) in the diabetic group. This change was significantly different from that of 2 nm (SD 37 nm) in control subjects (p=0.02). Mesangial volume fraction increased significantly by 0.04 (SD 0.03) in diabetic patients, and this change was significantly different from that of -0.01 (SD 0.04) in non-diabetic patients (p=0.009). No change was detectable in the matrix expressed as fraction of mesangial volume. An increase in interstitial volume fraction from baseline to 2 years was observed, but was significant only in the diabetic group (p=0.04). The changes in structural parameters did not correlate with mean values during follow-up of glycated haemoglobin or estimated protein intake, nor was any pattern discernible in the relationship to graft tissue types. The observed increase in basement membrane thickness corresponds to that observed in native kidneys during the first years of diabetes, whereas an increase in mesangial volume fraction — using a different protocol — was not observed in the early phase of the natural development. Absence of correlation with the various risk factors may reflect an irrelevance of these variables within the current range, or their influence may be offset by stronger mechanisms in the transplant situation, and therefore does not appear in this relatively small series.
    Type of Medium: Electronic Resource
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  • 10
    ISSN: 1432-0428
    Keywords: Key words Diabetic nephropathy ; diabetic glomerulopathy ; arteriolar hyalinosis ; juxtaglomerular arterioles ; extracellular matrix ; microalbuminuria ; stereology.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Hyalinization of juxtaglomerular arterioles is prominent in advanced diabetic nephropathy and may have important functional consequences. We studied the early stages of diabetic renal disease using kidney biopsy material from insulin-dependent diabetic patients, 8 with normal albumin excretion rate ( 〈 15 μg/min) and 16 with microalbuminuria (15–200 μg/min). Ten living non-diabetic kidney donors served as a control group. Median duration of diabetes was 9.5 years (range 5–31) in patients with normoalbuminuria, and 12 years (7–22) in patients with microalbuminuria (p = 0.27). The tissue was sectioned systematically, 1-μm thick sections for light microscopy at 10-μm intervals, and thin sections for electron microscopy taken at 60-μm intervals. The arterioles were identified as afferent or efferent, and total profiles were photographed (magnification 7500 × ), providing a systematic independent sample for measurements using standard stereological methods. Patients with microalbuminuria had significantly increased arteriole parameters compared with the control group: for afferent and efferent arterioles the volume fraction of matrix/media, means and (coefficient of variation, CV), was 0.47 (0.16) vs 0.33 (0.19) (p = 0.0009), and 0.62 (0.14) vs 0.45 (0.23) (p = 0.0004) and matrix-T , expressing amount of matrix per unit arteriolar surface, 2.38 (0.38) μm vs 1.44 (0.30) μm (p = 0.004), and 1.62 (0.28) μm vs 1.03 (0.34) (p = 0.0009). Patients with normoalbuminuria showed no significant differences from the control group, and had lower values than microalbuminuric patients for all parameters except the afferent matrix-T . In the normoalbuminuric group a correlation was found between parameters for afferent arterioles and those for glomerular structure. In conclusion there is arteriolar accumulation of extracellular material in the early phase of diabetic nephropathy, concomitant with early glomerulopathy. [Diabetologia (1995) 38: 1320–1327]
    Type of Medium: Electronic Resource
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