Glomerular involvement in diabetes may be classified based on the type of glomerular involvement.
Parameters:
(1) thickness of glomerular basement membrane (GBM) in electron microscopyin microns by sex
(2) mesangial expansion in percent
(3) Kimmelstiel-Wilson lesion (mesangial nodule)
(4) percent of glomeruli showing global glomerular sclerosis
|
GBM Thickness
|
Mesangial Expansion
|
Kimmelstiel Wilson lesion
|
Glomerular Sclerosis
|
Class
|
|
increased (see below)
|
<= 25%
|
0
|
<= 50%
|
I
|
|
NA
|
mild and > 25%
|
0
|
<= 50%
|
IIa
|
|
NA
|
severe and > 25%
|
0
|
<= 50%
|
IIb
|
|
NA
|
NA
|
>= 1
|
<= 50%
|
III
|
|
NA
|
NA
|
NA
|
> 50%
|
IV
|
|
GBM
|
Sex
|
Age
|
Increased?
|
|
<= 395 µm
|
F
|
NA
|
no
|
|
> 395 µm
|
F
|
NA
|
yes
|
|
<=430 µm
|
M
|
>= 9 years
|
no
|
|
> 430 µm
|
M
|
>= 9 years
|
yes
|
|
NA
|
M
|
< 9 years
|
NA
|
