Korean J Transplant.  2019 Dec;33(4):146-152. 10.4285/jkstn.2019.33.4.146.

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

Affiliations
  • 1Department of Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea. gmoolpop@gmail.com
  • 2Department of Pathology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea.

Abstract

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.

Keyword

Pancreas transplantation; Diabetic nephropathies; Calcineurin inhibitors

MeSH Terms

Biopsy, Needle
Calcineurin
Calcineurin Inhibitors
Diabetes Mellitus
Diabetes Mellitus, Type 1
Diabetic Nephropathies*
Female
Glucose
Humans
Kidney
Methods
Microscopy, Electron
Pancreas Transplantation*
Pancreas*
Proteinuria
Reference Values
Young Adult
Calcineurin
Calcineurin Inhibitors
Glucose
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