Characteristic Renal Histology of a 81-Year-Old Patient with a 30-Year History of Diabetes Mellitus: A Case Report
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CASE REPORT
Characteristic Renal Histology of a 81‑Year‑Old Patient with a 30‑Year History of Diabetes Mellitus: A Case Report Natsuki Shima1,5 · Naoki Sawa1 · Masayuki Yamanouchi1 · Hiroki Mizuno1 · Masahiro Kawada1 · Akinari Sekine1 · Rikako Hiramatsu1 · Noriko Hayami1 · Eiko Hasegawa1 · Tatsuya Suwabe1 · Junichi Hoshino1 · Kenmei Takaichi1,2 · Kenichi Ohashi3,4 · Takeshi Fujii3 · Yoshifumi Ubara1,2 Received: 22 December 2019 / Accepted: 21 April 2020 © The Author(s) 2020
Abstract A renal histology of an 81-year-old man with a 30-year history of diabetes mellitus (DM), as well as diabetic retinopathy and neuropathy, was examined. The patient’s blood pressure was controlled within the normal range (less than 140/75 mmHg) using antihypertensive agents including angiotensin receptor blocker. Edematous management was achieved by a strict salt diet (less than 6 g/per day). However, this patient’s glycemic control was poor with HbA1c 8–10%. Serum creatinine was 0.87 mg/dL and estimated globular filtration rate (eGFR) was 64 ml/min/1.73m2. Urinary protein excretion was 1.5 g/day. This patient’s renal biopsy showed linear staining for IgG along the GBM by immunofluorescence microscopy, but light microscopy showed almost intact glomeruli, and the GBM was not thickened as revealed by electron microscopy with a width of 288–368 nm (
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