Reversal of lesions of diabetic nephropathy after pancreas transplantation
Reversal of lesions of diabetic nephropathy after pancreas transplantation
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DOI：
10.1056/nejm199807093390202
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发表时间：
1998-07-09
影响因子：
158.5
通讯作者：
Mauer, M
中科院分区：
文献类型：
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作者：
Fioretto, P;Steffes, MW;Mauer, M
背景在没有尿毒症和没有接受过肾移植的1型糖尿病患者中，胰腺移植在移植后5年内不能改善糖尿病肾病的病变，方法我们对8例胰腺移植患者在术前、术后5年和10年进行了肾功能检查和肾活检1型糖尿病但无尿毒症，在移植时有轻度至晚期糖尿病肾病病变。结果所有患者移植后糖化血红蛋白值持续正常。中位尿白蛋白排泄率在移植前为103 mg/d，移植后5年为30 mg/d，移植后10年为20 mg/d（基线和5年值比较P=0.07;基线和10年值比较P=0.11）。平均（+/-SD）肌酐清除率从基线时的每1.73 m2体表面积108+/-20 ml/min下降到5年时的每1.73 m2体表面积74+/-16 ml/min（P
Background In patients with type 1 diabetes mellitus who do not have uremia and have not received a kidney transplant, pancreas transplantation does not ameliorate established lesions of diabetic nephropathy within five years after transplantation, but the effects of longer periods of normoglycemia are un known.Methods We studied kidney function and performed renal biopsies before pancreas transplantation and 5 and 10 years thereafter in eight patients with type 1 diabetes but without uremia who had mild to advanced lesions of diabetic nephropathy at the time of transplantation. The biopsy samples were analyzed morphometrically.Results All patients had persistently normal glycosylated hemoglobin values after transplantation. The median urinary albumin excretion rate was 103 mg per day before transplantation, 30 mg per day 5 years after transplantation, and 20 mg per day 10 years after transplantation (P=0.07 for the comparison of values at base line and at 5 years; P=0.11 for the comparison between base line and 10 years). The mean (+/-SD) creatinine clearance rate declined from 108+/-20 ml per minute per 1.73 m(2) of body-surface area at base line to 74+/-16 ml per minute per 1.73 m(2) at 5 years (P