Accelerated Kidney Aging in Diabetes Mellitus

Figure 1

Normal kidney, kidney aging in nature, and kidney aging under DM conditions. Each normal kidney possesses thousands of nephrons. With aging and the onset of DN and the interaction of the two, nephrons are gradually lost and become massive, particularly when occurring in aging kidneys with underlying DM. Macroscopically, pathologic reduction is observed in kidney size and renal histomorphology changes, including glomerulosclerosis, interstitial fibrosis, and tubular atrophy. Microscopically, compensatory hypertrophy of renal cells, glomerular basement membrane (GBM) thickening, podocyte loss, and tubular epithelial cell (TEC) shrinking are seen, which contribute to driving an associated dysfunction like the pathologic changes in kidneys as mentioned above.