The association of intercapillary glomerulosclerosis with a distinct clinical syndrome was first pointed out by Kimmelstiel and Wilson1 in 1936. They reported 8 cases in which different stages of the renal lesion were present. In all but 1 instance there was a history of diabetes mellitus. The characteristic symptom complex consisted of a history of diabetes mellitus, usually of long standing, widespread edema of renal origin and pronounced albuminuria. Frequently hypertension and renal insufficiency were also present. The renal lesion was characterized by focal hyalinization of the intercapillary connective tissue and was named intercapillary glomerulosclerosis.
The concomitant occurrence of these glomerular lesions with all or most of the manifestations of the typical syndrome was subsequently confirmed by Murakami,2 Anson,3 Derow, Altschule and Schlesinger,4 Newburger and Peter,5 Porter and Walker,6 Siegal and Allen,7 Herbut8 and Allen.9 The existence of intercapillary glomerusclerosis without a typical symptom complex was