Postmortem Renal Pathology in Diabetic Patients
Abstract
Background: Diabetes is considered the third cause of natural death annually around the globe because of its impact on various body systems such as the renal system as complications which in turn are the leading causes of death. The timing of these complications differ from one patient to another depending on his regular follow up and the commitment to medical advices given by his health care providers.
Objectives: To reveal the gross and histopathological changes in the kidneys after death among diabetic cases who are referred to a forensic institute for medico-legal causes
Methods: The study was conducted on 30 medico-legal autopsy cases referred to the medico-legal institute in Baghdad during the first 3 months of the year 2010, with a known history of diabetes. Information was provided by their relatives, police reports and from medical reports of those admitted to hospitals prior to death. After complete classical autopsy, kidneys were examined grossly and biopsies were taken and preserved in 10% formalin in order to be examined on another day histopathologically using hematoxylin and eosin stain.
Results: It was shown in the study that 27 were males and only 3 were females with a mean age 51.9±8.4 years. Eighteen of them were type 2 diabetes mellitus. Grossly 40% of cases were having small contracted kidneys with granular surface. Histologically diffuse glomerulosclerosis was seen in 90% of cases with thickening of the capillary basement membranes in 63.3%. Tubular atrophy was also present in 70% of them and chronic pyelonephritis in 36.7% while arteriosclerosis was seen in the vast majority of the specimens examined. More than one pathological lesion were seen in all cases
Conclusion: Contracted with granular surface kidneys were seen grossly in 40% of cases. Histologically diffuse glomerulosclerosis was seen in 90% of cases with tubular atrophy and chronic pyelonephritis in Type 1 and Type 2 diabetes and in different duration of the disease.
Keywords: Diabetes, Kidney, Autopsy, Histopathology.
Copyright (c) 2011 Iraqi Medical Journal
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