I Classici della Nefrologia Italiana. ''La nefropatia diabetica'' di Luigi Scapellato (1918-1998)

This monograph, published in 1953, describes the findings observed by the author in a cohort of patients affected by diabetes mellitus and renal disease. From a pathological standpoint, the typical renal lesion is represented by ''nodular intercapillary glomerulosclerosis'', which is present in 8 out of 20 patients at postmortem. Marked proteinuria and edema are the most typical clinical features. Urinary sediment examination is the only test allowing to differentiate diabetic nephropathy from other glomerular diseases. In the initial phases, the glomerular filtration rate is increased rather than reduced. The evolution is almost invariably towards end-stage renal disease, and a hypoglucidic diet and insulin are the only therapeutic modalities available. Today this work shows us, on the one hand, how many uncertainties still existed about diabetic nephropathy 17 years after its first description by Kimmelstiel and Wilson in 1936. On the other hand, it shows how much relevant and still valid information was already known at the time. Luigi Scapellato, who is almost completely forgotten today, began his career at the Clinica Medica of the University of Rome under the guidance of Cesare Frugoni (1881-1978). In 1959, he moved to Syracuse (Sicily) to work as director of the internal medicine unit of the ''Umberto I'' Hospital. In April 1957 he was among the 13 founders of the Italian Society of Nephrology.