Volume 81, Issue 5, Pages 486-493 (March 2012) Glomerular hyperfiltration and increased glomerular filtration surface are associated with renal function decline in normo- and microalbuminuric type 2 diabetes  Tatsumi Moriya, Akiko Tsuchiya, Shin-ichiro Okizaki, Akinori Hayashi, Keiji Tanaka, Masayoshi Shichiri  Kidney International  Volume 81, Issue 5, Pages 486-493 (March 2012) DOI: 10.1038/ki.2011.404 Copyright © 2012 International Society of Nephrology Terms and Conditions

Figure 1 Relationship between the glomerular filtration rate (GFR) and electron microscopic morphometry. In total, 30 type 2 diabetic patients without nondiabetic renal histological changes were measured for their GFR using iohexol injection. The surface density of the peripheral glomerular basement membrane (Sv(PGBM/glom)) (a) and the volume fraction of the mesangium (Vv(Mes/glom)) (b) were compared with the baseline GFR data. The straight line in a indicates a statistically significant linear regression line (GFR=449.2 × Sv(PGBM/glom)+68.6; r=0.54; P<0.01). Kidney International 2012 81, 486-493DOI: (10.1038/ki.2011.404) Copyright © 2012 International Society of Nephrology Terms and Conditions

Figure 2 Relationship between the glomerular filtration rate (GFR) of the patients and the time after renal biopsy. All GFR values at baseline and follow-up periods were plotted sequentially. The straight line in the panel denotes a linear regression line of all GFR values (GFR=-0.195 × month+128.128; r=0.23; P=0.0003). Kidney International 2012 81, 486-493DOI: (10.1038/ki.2011.404) Copyright © 2012 International Society of Nephrology Terms and Conditions

Figure 3 Serial changes of the glomerular filtration rate (GFR) and urinary albumin excretion (UAE) in 22 patients who underwent at least five GFR follow-up measurements. The GFR values showed a significant linear decrease in 9 patients (a), a parabolic increase followed by a decrease in 2 patients (b), and no significant increment or decline of the GFR in 11 patients (c). Closed circles represent individual GFR values plotted against the time after the renal biopsy. Open, shadowed, and closed horizontal panels at the top of each panel represent the period showing normoalbuminuria, microalbuminuria, or overt proteinuria, respectively. Kidney International 2012 81, 486-493DOI: (10.1038/ki.2011.404) Copyright © 2012 International Society of Nephrology Terms and Conditions

Figure 4 Correlation between the surface density of peripheral glomerular basement membrane (Sv(PGBM/glom)) and the change in the glomerular filtration rate (GFR) during the subsequent year. Sv(PGBM/glom) was measured using the line intercept method and plotted against the change in GFR values obtained from the difference between the GFR measured at the renal biopsy and at 1 year (a) or 5 years (b) later. Kidney International 2012 81, 486-493DOI: (10.1038/ki.2011.404) Copyright © 2012 International Society of Nephrology Terms and Conditions

Figure 5 Relationship between a glomerular filtration rate (GFR) value and subsequent GFR change during the 1-year period. All GFR values measured at the renal biopsy and at follow-up after the renal biopsy were plotted against the GFR change during the 1-year period. Kidney International 2012 81, 486-493DOI: (10.1038/ki.2011.404) Copyright © 2012 International Society of Nephrology Terms and Conditions

Figure 6 Relationships between urinary albumin excretion (UAE) at the renal biopsy and renal function. UAE values obtained at renal biopsy were plotted against the baseline GFR values (a), the change in the GFR during the 1-year period (b), and during the 5 years (c) following the renal biopsy. Kidney International 2012 81, 486-493DOI: (10.1038/ki.2011.404) Copyright © 2012 International Society of Nephrology Terms and Conditions