A 55-year-old man with a 10-year history of type 2 diabetes and hypertension presents with nephrotic-range proteinuria and progressive renal dysfunction. Current vitals: BP 158/92 mmHg, HR 88, RR 16, SpO2 98% on room air. Labs reveal serum creatinine 2.1 mg/dL and urine protein 4.2 g/24 hours. Renal biopsy demonstrates nodular glomerulosclerosis with mesangial matrix expansion and hyaline deposits in afferent arterioles. No immune complex deposition is noted on immunofluorescence. Which histopathologic feature is most characteristic of this patient's underlying renal disease?
- A)Foot process effacement
- B)Subepithelial immune deposits
- C)Double basement membrane appearance
- D)Kimmelstiel-Wilson nodulesGABARITO
- E)Crescents in Bowman's space
Explicação
Kimmelstiel-Wilson nodules are pathognomonic for diabetic nephropathy, characterized by nodular glomerulosclerosis in the mesangium. Combined with mesangial expansion, afferent arteriole hyalinosis, and the patient's diabetes history, this confirms diabetic gl... Ver explicação completa e trilha adaptativa →