Tanaka Ryo, Imamura Ryoichi, Matsumura Soichi, Fukae Shota, Taniguchi Ayumu, Nakazawa Shigeaki, Yamanaka Kazuaki, Namba-Hamano Tomoko, Kakuta Yoichi, Takao Tetsuya, Fushimi Hiroaki, Nonomura Norio
Department of Urology, Osaka University Graduate School of Medicine, Osaka, Japan,
Department of Urology, Osaka University Graduate School of Medicine, Osaka, Japan.
Nephron. 2024;148(7):468-473. doi: 10.1159/000535877. Epub 2024 Mar 8.
Although glomerular damage caused by diabetic nephropathy was thought to be irreversible, in recent years, there have been reports on improvement in glomerular damage with strict glycemic control. However, few reports are available on the pathologic course after renal transplantation of donor-derived grafts with findings of diabetic nephropathy. A 53-year-old woman underwent an ABO blood-type compatible living-donor renal transplant. The recipient had no history of diabetes, and fasting blood glucose and hemoglobin A1c levels were both normal. The donor was a 57-year-old male who had received treatment for type 2 diabetes mellitus for 10 years. Transplant renal biopsy performed 1 h after revascularization showed mesangial matrix expansion and arterial hyalinosis due to diabetic nephropathy. The blood glucose level was within the normal range after transplantation. Mesangial matrix expansion and arterial hyalinosis disappeared in allograft biopsy samples 7 years after transplantation. We observed significant improvement in the pathological findings of donor-derived diabetic nephropathy after renal transplantation in the subsequent follow-ups.
尽管糖尿病肾病所致的肾小球损伤曾被认为是不可逆的，但近年来，有报告称严格控制血糖可改善肾小球损伤。然而，关于患有糖尿病肾病的供体来源移植物肾移植后的病理过程，相关报告较少。一名53岁女性接受了ABO血型相合的活体供肾移植。受者无糖尿病病史，空腹血糖和糖化血红蛋白水平均正常。供者为一名57岁男性，患2型糖尿病10年并接受过治疗。血管再通后1小时进行的移植肾活检显示，由于糖尿病肾病导致系膜基质扩张和动脉玻璃样变。移植后血糖水平在正常范围内。移植7年后，同种异体移植肾活检样本中的系膜基质扩张和动脉玻璃样变消失。在随后的随访中，我们观察到供体来源的糖尿病肾病在肾移植后的病理表现有显著改善。
