Idiopathic nodular glomerulosclerosis is a distinct clinicopathologic entity linked to hypertension and smoking

Authors: Markowitz GS, Lin J, Valeri AM, et al.

Publication: Hum Pathol 33: 826-835, 2002

Idiopathic nodular sclerosis mimics diabetic glomerulosclerosis, but occurs in patients with no clinical evidence of diabetes mellitus.  This study reviews a cohort of these patients biopsied between 1996 and 2001.  The patients were more often older, Caucasian, and male.  They presented with renal insufficiency, proteinuria often nephrotic-range, and usually had hypertension, hypercholesterolemia and were smokers.  The renal biopsies were characterized by diffuse nodular mesangial sclerosis, thickened basement membranes and arterial sclerosis.  Combined afferent and efferent arteriolar hyalinosis, once thought to be diagnostic of diabetic damage can also be seen. Immunofluorescence showed low intensity linear staining of all basement membranes in nearly half of the cases.