Effect of Kimmelstiel–Wilson Syndrome on Insulin Requirements in Diabetes

Abstract

ALESION of the renal glomeruli associated clinically with diabetes, albuminuria, hypertension and edema of the nephrotic type was described by Kimmelstiel and Wilson¹ in 1936. The clinical features of the syndrome have been well defined.^{2 , 3} Pathologically, the "nodular" glomerular lesion is generally accepted as specific.² The pathogenesis of this disease is poorly understood. Rich, Berthrong and Bennett⁴ described renal lesions resembling those of intercapillary glomerulosclerosis in rabbits given intramuscular injections of cortisone. Friedenwald⁵ presented clinical and experimental evidence that relative adrenal hyperfunction with possible associated vitamin B₁₂ deficiency is causally related to the development of both glomerular and retinal . . .