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===Staging===
To clinically stage the degree of damage in this (and any) kidney disease, the serum creatinine is determined and used to calculate the estimated glomerular filtration rate ([[Estimated Glomerular Filtration Rate|eGFR]]). Normal eGFR is equal to or greater than 90ml/min/1.73 m<sup>2</sup>.
On biopsy, the following classification has been suggested by Tervaert ''et al.'':
{|class=wikitable
|+Histopathologic staging
! Class !! Description and criteria
|-
| I || Mild or nonspecific changes on light microscopy and conformed GBM<br>thickening proven by electron microscopy: GBM > 395 nm (female), GBM > 430 nm (male).
|-
| IIa
|
* Mild mesangial expansion in >25% of the observed mesangium.
* Area of mesangial proliferation < area of capillary cavity.
|-
| IIb
|
* Severe mesangial expansion in >25% of the observed mesangium.
* Area of mesangial proliferation < area of capillary cavity.
|-
| III
| At least one convincing nodular sclerosis (Kimmelstiel-Wilson lesion).
|-
| IV
| Advanced diabetic glomerulosclerosis in >50% of glomeruli.
|}

Translations:Diabetic nephropathy/17/en - Revision history

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