Our observation that glomerular and tubular expression of PAI-1 is increased in DM+ATH pigs is noteworthy due to the fact that: 1) PAI-1 was found to be prominently expressed in Kimmelstiel-Wilson nodules, in particular those with active microvascular damage [25]; 2) unilateral ureteral obstruction [43] and glomerulonephritis [44] have also been associated with increased expression of tubular PAI-1; and 3) endogenous PAI-1 deficiency protects diabetic mice from glomerular injury [45]. This evidence concerns the gene SERPINE1 and Ureteral obstruction.