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Diagnosis: Diabetic Nephropathy - Mild chronic changes

Although not ideal for transplantation, kidneys with established diabetic nephropathy (including nodular glomerulosclerosis and thickening of mesangial matrix and capillary basement membranes) can be successfully transplanted. Histologic lesions can reverse.

In our case one kidney was transplanted into a female hypersensitized. The kidney worked relatively well for the first 5 days, but then creatinine began to rise, oliguria presented and a biopsy showed features of acute AMR. Despite treatment, there was graft loss a month later. The nephrectomy specimen was completely necrotic and it was not possible to assess the lesions of diabetes. The other kidney was discarded.

See the chapter The kidney in diabetes mellitus and other... of our tutorial.

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References

• Fioretto P, Caramori ML, Mauer M. The kidney in diabetes: dynamic pathways of injury and repair. The Camillo Golgi Lecture 2007. Diabetologia. 2008 Aug;51(8):1347-55. [PubMed link]
• Makino H, Nakamura Y, Wada J. Remission and regression of diabetic nephropathy. Hypertens Res. 2003 Jul;26(7):515-9. [PubMed link]
• Abouna GM, Al-Adnani MS, Kremer GD, Kumar SA, Daddah SK, Kusma G. Reversal of diabetic nephropathy in human cadaveric kidneys after transplantation into non-diabetic recipients. Lancet. 1983;2(8362):1274-6. [PubMed link]

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