Kimmelstiel-Wilson disease is diagnostic of: (AIPG 2011)
a. Diabetic Glomerulosclerosis
The renal involvement occur as:
i. Non-nephrotic proteinuria; nephrotic syndrome and chronic renal failure
ii. There is afferent arteriolar sclerosis and risk of papillary necrosis
i. Nodular glomerulosclerosis (pathognomic) or intercapillary glomerulosclerosis or Kimmelstiel Wilson disease
ii. Capillary basement membrane thickening
iii. Diffuse glomerulosclerosis
iv. Fibrin cap
v. Capsular drop
This renal pathology is more frequent and severe and more progressive in insulin dependent diabetes mellitus.
a. Permanent renal damage can develop in as little as 5 years after diabetes mellitus.
b. The spilling of albumin into the urine and, more specifically, the spilling of very small levels of albumin ("microalbuminuria") are the best markers to date for significant diabetic nephropathy.
c. Hypertension often coexists with, and apparently favors the development of, microalbuminuria, but is not a specific marker for renal damage.