Diabetic microangiopathy. I. Current status of the chemistry and metabolism of the glomerular basement membrane.

In recent years, the nature of the renal glomerular basement membrane has been the subject of numerous investigations. In diabetes mellitus, the renal glomerulus is characterized primarily by thickening of the basement membrane and excessive accumulation of basement membrane-like material in the mesangial region. Compositional analyses have shown that basement membranes are glycoprotein in nature. Studies of the glomerular basement membranes in diabetes have indicated a change from normal chemical composition. Furthermore, studies of the metabolism of diabetic kidneys in experimental animals, using cortical homogenates and isolated glomeruli, have demonstrated higher anabolic and lower catabolic enzyme activities. However, contradictory data have been reported with regard to both the chemical composition and metabolism of the kidney in human and experimental diabetes. This review attempts to examine these reports in detail and discuss the possible causes for these discrepancies.