Which one of the listed statements best characterizes the renal abnormality described as Kimmelstiel-Wilson disease?
Correct Answer: Nodular glomerulosclerosis
Description: Diabetes may produce abnormalities that affect any pa of the kidney, such as the glomerulus, the blood vessels (benign nephrosclerosis), the tubules (Armanni-Ebstein lesions, which refers to vacuolization of the cells of the proximal convoluted tubules), the interstitium, and the pelvis (infection leads to pyelonephritis and acute papillary necrosis). Diabetic lesions of the glomerulus include capillary basement thickening, diffuse glomerulosclerosis (increase in mesangium and mesangial cells), and nodular glomerulosclerosis. The latter refers to oval hyaline masses at the periphery of the glomerulus and is also called Kimmelstiel-Wilson disease. Nodular glomeruloscleroses may resemble amyloid, and, if they are present, amyloid staining should be done. Other characteristic lesions found in the glomerulus include "capsular drops" (round nodules found between Bowman's capsule and the parietal epithelium) and "fibrin caps" (subendothelial accumulations along capillary loops).
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