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Kidney non-tumor

Primary glomerular diseases

Idiopathic nodular glomerulosclerosis


Reviewers: Nikhil Sangle, M.D. (see Reviewers page)
Revised: 10 January 2013, last major update May 2012
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.

General
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● Resembles nodular diabetic glomerulosclerosis (Kimmelstiel-Wilson changes), but in non-diabetic patients
● Mean age 68 years, 74% white and 78% men (Hum Pathol 2002;33:826)
● Typically presents with renal insufficiency (83%, mean serum creatinine of 2.4 mg/dL), proteinuria > 3g/day (70%) and nephrotic syndrome (22%)
● Associated with hypertension (96%), smoking (91%, mean 53 pack-years), hypercholesterolemia (90%) and extrarenal vascular disease (44%, Hum Pathol 2002;33:826); also increased body mass index / overweight (Hum Pathol 2008;39:1771)
● A diagnosis of exclusion
Poor prognostic factors for end stage renal disease: continued smoking, lack of angiotensin II blockage and degree of arteriosclerosis

Micro description
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● Prominent diffuse and nodular mesangial sclerosis, glomerular basement membrane thickening, arteriosclerosis and arteriolosclerosis
● Also neovascularization of glomeruli

Micro images
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Idiopathic nodular glomerulosclerosis

Positive stains
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● CD34 highlights increased number of vascular channels within glomeruli compared with normal controls

Differential diagnosis
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Table

End of Kidney non-tumor > Primary glomerular diseases > Idiopathic nodular glomerulosclerosis

Ref Updated: 4/27/12


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