International experts on renal disease in agreement
Jan Anthonie Bruijn, a pathologist at the LUMC, has devised a classification for renal disease arising from diabetes. The classification is published in the online version of the Journal of the American Society of Nephrology. There had previously not been any uniform system of classification.
Stages
The classification is the result of a collaboration between experts at 16 universities in 7 countries, with Professor Bruijn heading the research. They divided the gradual deterioration of the kidneys into four clearly described stages. This system will enable pathologists in the clinical environment to characterise patients more easily, which will have important benefits for doctors, patients and researchers. Doctors will be able to use the classification to make a clear diagnosis and provide patients with the most appropriate treatment, and researchers will be able to unravel the mechanisms underlying the process of the disease.
Dialysis
Kidney disease in diabetes patients is a major and growing problem; it is already the primary cause of kidney failure. It is estimated that in 2010 there will be 285 million diabetes sufferers worldwide. The disease damages blood vessels. The kidneys, with their many filtering devices (glomeruli) in which fine capillaries branch out into tight knots are very sensitive to such damage. Connective tissue accumulates in these filter devices, which stops them doing their work - filtering out waste products from the blood - properly. The connective tissue gradually increases until eventually the kidney is so damaged that dialysis or a kidney transplant is necessary.
The classification is based on the amount of connective tissue formed in and outside the filter devices.
(19 February 2010/LUMC)