Pancreas transplantation and reversal of diabetic nephropathy lesions

Pancreas transplantation is the only available treatment that has restored long-term (10 or more years) normoglycemia without the risks of severe hypoglycemia, allowing testing of the reversibility of diabetic nephropathy lesions. The authors studied renal structure before and 5 and 10 years after p...

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Bibliographic Details
Published inThe Medical clinics of North America Vol. 97; no. 1; p. 109
Main Authors Mauer, Michael, Fioretto, Paola
Format Journal Article
LanguageEnglish
Published United States 01.01.2013
Subjects
Adult
Biopsy
Diabetes Mellitus, Type 1 - blood
Diabetes Mellitus, Type 1 - complications
Diabetes Mellitus, Type 1 - surgery
Diabetic Nephropathies - etiology
Diabetic Nephropathies - pathology
Diabetic Nephropathies - physiopathology
Female
Glycated Hemoglobin - analysis
Graft Survival
Humans
Kidney Glomerulus - pathology
Kidney Glomerulus - physiopathology
Male
Monitoring, Physiologic - methods
Pancreas Transplantation - methods
Time
Treatment Outcome
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Summary:Pancreas transplantation is the only available treatment that has restored long-term (10 or more years) normoglycemia without the risks of severe hypoglycemia, allowing testing of the reversibility of diabetic nephropathy lesions. The authors studied renal structure before and 5 and 10 years after pancreas transplantation in nonuremic patients with long-term type 1 diabetes, with established diabetic nephropathy lesions at baseline. Diabetic glomerular lesions were not significantly changed at 5 years but were dramatically improved after 10 years, with most patients' glomerular structure returning to normal at the 10-year follow-up. These studies also showed that tubulointerstitial remodeling was also possible.
ISSN:1557-9859
DOI:10.1016/j.mcna.2012.10.009