Fig. 4

52 year old diabetic male with stage IV CKD average RRI = 0.73 and Histopathology showed increase in mesangial matrix and cells. Capillary loops were patent with thick single contoured basement membrane. KW nodules were seen. Intimal fibroplasia and medial hyperplasia of large arteries noted with intimal thickening more than medial thickening. Tubular atrophy and interstitial fibrosis was seen in ~ 55–60% of the sampled area. Findings were consistent with Class IV diabetic nephropathy (GS 3, AT 4, TI 3)