In 1936 Kimmelstiel and Wilson1 reported on a group of 8 patients showing a striking hyaline thickening of the intercapillary connective tissue, most clearly seen at the hilus of the glomeruli. They felt that the change was degenerative and suggested that arteriosclerosis and diabetes mellitus played a part in its causation. The most significant clinical features of their cases were diabetes mellitus, usually of long duration, edema of the nephrotic type, gross albuminuria and varying degrees of hypertension.
This report is concerned with an analysis of the clinical and laboratory features of 8 patients who had mild diabetes mellitus, 6 of these showing at autopsy the intercapillary lesions in the glomeruli as described by Kimmelstiel and Wilson. Permission for autopsy on the other 2 was not obtained but we feel that their clinical course justifies the conclusion that they too would have shown these changes in the kidney.
PORTER WB, WALKER H. THE CLINICAL SYNDROME ASSOCIATED WITH INTERCAPILLARY GLOMERULOSCLEROSIS. JAMA. 1941;116(6):459–464. doi:10.1001/jama.1941.02820060007002