Vascular endothelial growth factor expression in diabetic nephropathy; a clinico-pathological study

Diabetes is an illness of epidemic magnitude, and the figures are rising each year. Diabetic nephropathy (DN) is a dreaded long-term complication of diabetes and the most common reason for end-stage renal disease (ESRD). Microalbuminuria is considered as a non-invasive indicator of early onset of DN. Renal biopsy is vital to know the extent of renal damage. Vascular endothelial growth factor (VEGF) plays a key role in angiogenesis and has been implicated in the pathogenesis and development of the disease.

To assess the expression of VEGF in different classes of DN and to evaluate its association with the known clinical and histopathological prognostic factors. Patients and

Fifty-five patients of DN undergoing a renal biopsy were studied and classified according to the “pathologic classification of DN” by Tervaert et al. Glomerular and tubular staining of VEGF was recorded. P values of less than 0.05 were considered statistically significant.

Of 55 patients, eight patients belonged to class II, 24 to class III, and 23 to class IV. VEGF was positive in six (75%) of class II, 17 (70.83%) of class III and eight (34.7%) of class IV biopsies. A statistically significant correlation between classes of DN with estimated glomerular filtration rate (eGFR), serum creatinine, serum urea, diabetic retinopathy, hematuria, VEGF positivity and staining intensity was observed.

A precise assessment of renal damage in DN can be conducted by studying renal biopsies. VEGF expression is increased in the early stage of diabetes however; further studies could open up new avenues for early diagnosis and management.