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Recurrence of diabetic kidney disease in a type 1 diabetic patient after kidney transplantation
Author(s) -
Nyumura Izumi,
Honda Kazuho,
Babazono Tetsuya,
Horita Shigeru,
Murakami Toru,
Fuchinoue Shohei,
Uchigata Yasuko
Publication year - 2015
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/nep.12454
Subject(s) - medicine , calcineurin , diabetes mellitus , kidney , kidney transplantation , transplantation , urology , kidney disease , surgery , toxicity , gastroenterology , endocrinology
Post‐transplant hyperglycaemia of diabetic patients may cause recurrent diabetic kidney disease ( DKD ) in kidney allografts. We report a patient with slowly progressive DKD with calcineurin inhibitor toxicity ( CNI ) toxicity after the kidney transplantation. A 28‐year‐old female with type 1 diabetes mellitus underwent successful kidney transplantation from her mother in A pril 2003, and the kidney graft survived for more than 10 years. She was treated with combined immunosuppressive therapy consisting of cyclosporine and mycophenolate mofetil. After transplantation, she continued to take insulin injection four times per day, but her glycosylated haemoglobin (HbA1c) was above 10%. Protocol allograft kidney biopsies performed 5 and 10 years after transplantation revealed the recurrence of slowly progressive diabetic kidney disease. In addition, arteriolar hyalinosis partly associated with calcineurin inhibitor toxicity ( CNI ) was detected with progression. Post‐transplant hyperglycaemia causes recurrent diabetic kidney disease ( DKD ) in kidney allografts, but its progression is usually slow. For long‐term management, it is important to prevent the progression of the calcineurin inhibitor arteriolopathy, as well as maintain favourable glycaemic control.