Nodular glomerulosclerosis is associated with:September 2009 and 2011, September 2012

Ans. D: Diabetes MellitusNodular glomerulosclerosis refers to a histologic pattern of nodular mesangial sclerosis with accentuated, lobular-appearing glomeruli on renal biopsy.Although nodular glomerulosclerosis is classically described in association with diabetes (the so-called "KimmelstielWilson lesion"), the lesion is not pathognomonic for diabetic nephropathy. In fact, a number of renal conditions have been seen in association with this distinctive, histologic pattern.The differential diagnosis of non-diabetic, nodular glomerulosclerosis includes, but is not limited to:Immunotactoid glomerulosnephritisFibrillary glomerulosnephritisFibronectin glomerulosnephritisCryoglobulinemic glomerulosnephritisAmyloidosisLight Chain Deposition Disease (LCDD)Heavy Chain Deposition Disease (HCDD)Idiopathic Nodular GlomerulosclerosisIn order to determine the specific disease responsible for nodular glomerulosclerosis, a deliberate inspection of the renal biopsy (paicularly, Congo red staining) is required.The diagnosis of "idiopathic" nodular glomerulosclerosis remains one of exclusion.