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Progression of diabetic nephropathy after successful pancreas transplantation alone: a case report

Pancreas transplantation is the only method that can nearly cure insulin-dependent diabetes mellitus. However, the effect of pancreas transplantation on patients with diabetic nephropathy has recently been considered controversial. In this report, we present a case of abrupt aggravation of proteinur...

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Detalles Bibliográficos
Autores principales: Kim, Yoonhong, Kim, Dong Il, Shim, Jae Ryong, Lee, Tae Beom, Yang, Kwang Ho, Ryu, Je Ho, Lee, Hyun Jung, Choi, Byung Hyun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society for Transplantation 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9188945/
https://www.ncbi.nlm.nih.gov/pubmed/35769979
http://dx.doi.org/10.4285/jkstn.2019.33.4.146
Descripción
Sumario:Pancreas transplantation is the only method that can nearly cure insulin-dependent diabetes mellitus. However, the effect of pancreas transplantation on patients with diabetic nephropathy has recently been considered controversial. In this report, we present a case of abrupt aggravation of proteinuria after successful pancreas transplantation alone without evidence of calcineurin inhibitor (CNI) toxicity. A 22-year-old female patient with type I diabetes mellitus underwent pancreas transplantation alone. The patient already had retinopathy and mild proteinuria, which in this case, may mean diabetic nephropathy. Her glucose levels were managed within the normal range after successful pancreas transplantation. However, the amount of proteinuria fluctuated. Kidney needle biopsy was performed owing to severe elevation of proteinuria, 2 years after the transplantation. Electron microscopy revealed diabetic glomerulosclerosis without evidence of CNI toxicity. This case indicates that diabetic nephropathy can be aggravated after pancreas transplantation, despite well-managed glucose levels and absence of CNI toxicity.