Gimenez L F, Watson A J, Burrow C R, Olson J L, Klassen D K, Cooke C R
Am J Nephrol. 1986;6(5):378-81. doi: 10.1159/000167196.
Recurrence of diabetic nephropathy in the allograft of diabetics with end-stage renal disease who undergo renal transplantation has been reported. We report a case of a patient who underwent cadaveric renal transplantation for end-stage renal disease secondary to chronic glomerulonephritis 13 years ago. He developed steroid-induced, insulin-dependent diabetes mellitus 9 months after transplantation and florid nephrotic syndrome with progressive functional impairment due to biopsy-proven diabetic nephropathy 11 years later. This is, to our knowledge, the first report of de novo diabetic nephropathy in a renal allograft of a patient who was not a diabetic at the time of transplantation. It is suggested that histopathologic changes of diabetes mellitus cannot only recur in a renal allograft, but also can develop de novo and lead to functional impairment and ultimately affect graft survival. In view of increasing patient and graft survival in transplanted diabetic and non-diabetic patients, it is reasonable to anticipate an increased incidence of this complication.
已有报道称，患有终末期肾病的糖尿病患者在接受肾移植后，同种异体移植肾会出现糖尿病肾病复发。我们报告了一例患者，该患者13年前因慢性肾小球肾炎继发终末期肾病接受了尸体肾移植。移植9个月后，他出现了类固醇诱导的胰岛素依赖型糖尿病，11年后，经活检证实为糖尿病肾病，出现了明显的肾病综合征并伴有进行性功能损害。据我们所知，这是首例关于移植时非糖尿病患者的同种异体移植肾发生新发糖尿病肾病的报告。这表明糖尿病的组织病理学改变不仅会在同种异体移植肾中复发，还可能新发并导致功能损害，最终影响移植肾存活。鉴于移植的糖尿病和非糖尿病患者的患者及移植肾存活率不断提高，可以合理预期这种并发症的发生率会增加。
