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J. A. ROBERTSON, M.B., M.R.C.P.; C. H. GRAY, M.D., M.Sc.; A. H. BAYNES, M.B., M.R.C.P.
AMA Arch Intern Med. 1951;87(4):570-582. doi:10.1001/archinte.1951.03810040095007.
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THE RECOGNITION of a possibly specific renal lesion developing in treated diabetics is due to Kimmelstiel and Wilson.1 They observed at autopsy a hyalinization of the intercapillary connective tissue of the glomeruli in seven diabetic patients who during life had shown evidence of renal dysfunction. This finding has been fully confirmed by a number of American workers and in this country by Gauld, Stalker and Lyall2 and Hall.3

The clinical syndrome associated during life with the specific kidney lesion comprises hypertension, albuminuria and retinopathy; edema is a less constant finding. Death usually occurs either from a cardiovascular accident or from uremia. Most writers on this subject4 agree that the presence of the lesion at autopsy may be anticipated during life with a fair degree of certainty if the above clinical syndrome is noted in a patient with long-standing diabetes and in whom there is no previous


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