Molecular biology of diabetic glomerulosclerosis

Diabetic nephropathy is one of the leading causes of renal failure in Weste rn countries, where diabetic patients account for nearly half of all patien ts on haemodialysis. Progressive expansion of the mesangial matrix, and thi ckening of the glomerular and tubular basement membranes without signs of m ajor cell proliferation are hallmarks of human and experimental diabetic ne phropathy. These lesions eventually lead to glomerular fibrosis, a central pathological feature in many human acute and chronic kidney diseases, which progressively destroys the renal filtration unit, and may finally cause re nal failure. Indeed, structure-function relationship studies have shown tha t mesangial matrix expansion is strongly related to the clinical manifestat ion of diabetic nephropathy.