Diabetic nephropathy may be associated with changes in the interstitium and renal arteries.
Testing: renal biopsy
Parameters:
(1) interstitial fibrosis and tubular atrophy (IFTA) in percent
(2) interstitial inflammation
(3) arteriolar hyalinosis
(4) large vessel arteriosclerosis (worst artery)
|
Parameter
|
Finding
|
Points
|
|
IFTA
|
none (0%)
|
0
|
|
|
1 to 24.9%
|
1
|
|
|
25 to 50%
|
2
|
|
|
> 50%
|
3
|
|
interstitial inflammation
|
absent
|
0
|
|
|
only in relation to IFTA
|
1
|
|
|
in areas without IFTA
|
2
|
|
arteriolar hyalinosis
|
none
|
0
|
|
|
1 area
|
1
|
|
|
2 or more areas
|
2
|
|
large vessel arteriosclerosis
|
no intimal thickening
|
0
|
|
|
intimal thickening less than thickness of media
|
1
|
|
|
intimal thickening greater than thickness of media
|
2
|
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum interstitial subscore: 5
• maximum vascular subscore: 4
• maximum total score: 9
