Renal Function in Diabetic Nephropathy

THE RECOGNITION of a possibly specific renal lesion developing in treated diabetics is due to Kimmelstiel and Wilson.1They observed at autopsy a hyalinization of the intercapillary connective tissue of the glomeruli in seven diabetic patients who during life had shown evidence of renal dysfunction. This finding has been fully confirmed by a number of American workers and in this country by Gauld, Stalker and Lyall2and Hall.3 The clinical syndrome associated during life with the specific kidney lesion comprises hypertension, albuminuria and retinopathy; edema is a less constant finding. Death usually occurs either from a cardiovascular accident or from uremia. Most writers on this subject4agree that the presence of the lesion at autopsy may be anticipated during life with a fair degree of certainty if the above clinical syndrome is noted in a patient with long-standing diabetes and in whom there is no previous