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Ali K. Owda, Abdallah H. Abdallah, Abdul Haleem, Fahad A. Hawas, Dujana Mousa, Halima Fedail, Mohamed H. Al-Sulaiman, Abdullah A. Al-Khader, De novo diabetes mellitus in kidney allografts: nodular sclerosis and diffuse glomerulosclerosis leading to graft failure, Nephrology Dialysis Transplantation, Volume 14, Issue 8, August 1999, Pages 2004–2007, https://doi.org/10.1093/ndt/14.8.2004
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Introduction
Post-transplant diabetes mellitus (PTDM) is a well-recognized clinical problem following renal transplantation, and occurs with incidence rates that range between 2.5 and 20% [1–4]. Despite this high incidence, there are very few reported cases of diabetic nephropathy of the diffuse type [5,6] and only a single report of the nodular sclerosis form [7].
We report (i) patient who developed PTDM 8 months after renal transplantation, with progression to the nephrotic syndrome and end-stage renal failure due to typical diabetic nodular sclerosis of Kimmelstiel—Wilson, and (ii) patients who developed PTDM 6 months and 2 years after renal transplantation respectively, who progressed to the nephrotic syndrome with impaired renal function due to diffuse diabetic glomerulosclerosis.
Cases
Case 1
A 48-year-old woman who was neither diabetic nor hypertensive presented with chronic renal failure. She had no family history of diabetes mellitus and her kidney ultrasound demonstrated bilateral small kidneys.
She was maintained on haemodialysis for 30 months before she had a cadaver renal transplant in May 1986. The donor was not diabetic, and a biopsy of the allograft performed during the transplant operation showed a kidney of normal histology apart from mild non-specific mesangial proliferation (Figure 1).
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