Diabetic Kidney Disease: Pathophysiology and Therapeutic Targets

Figure 1

(a) Light microscopy with hematoxylin-eosin staining reveals extensive mesangial expansion without marked increase in cellularity. A Kimmelstiel-Wilson (KW) lesion is shown here and refers to the nodular glomerulosclerosis that can be seen in late disease but is not as common as diffuse diabetic glomerulosclerosis. KW lesions are usually spherical and eosinophilic and have a central hypocellular or acellular area. Mesangial expansion and KW lesions are both due to increased extracellular matrix production. (b) Electron microscopy reveals a thickened basement membrane and podocyte foot process effacement.

(a)

(b)