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Secondary focal segmental glomerulosclerosis following kidney transplantation in a patient with type I diabetes mellitus
- Source :
- Clinical Transplantation. 20:7-10
- Publication Year :
- 2006
- Publisher :
- Wiley, 2006.
-
Abstract
- Although recurrent diabetic nephropathy is common in patients with type I diabetes after kidney transplantation, the development of focal segmental glomerulosclerosis (FGS) is rare, and its development generally takes several years. We report here a case of type I diabetes mellitus with secondary FGS accompanied by proteinuria 10 months following kidney transplantation. Episode biopsy showed secondary FGS, evidenced by glomerular capillary collapse and large epithelial cells with ballooning degeneration. Exudative dense deposition of IgM in a diffuse global mesangial pattern and enlarged glomerular diameters were observed, suggestive of glomerular hyperfiltration which can lead to secondary FGS. An imbalance in body size between donor and recipient and/or uncontrolled diabetes are potential causes of glomerular hyperfiltration. We administered angiotensin-converting enzyme inhibitor and angiotensin II receptor blocker to reduce hyperfiltration-induced renal damage; the combination therapy reduced proteinuria from 2346 to 258 mg/d. Secondary FGS should be a consideration after kidney transplantation in patients with type I diabetes mellitus.
- Subjects :
- Adult
Male
medicine.medical_specialty
Urology
Tetrazoles
Angiotensin-Converting Enzyme Inhibitors
Diabetic nephropathy
Focal segmental glomerulosclerosis
Lisinopril
Diabetes mellitus
Internal medicine
Humans
Medicine
Kidney transplantation
Transplantation
Glomerulosclerosis, Focal Segmental
urogenital system
business.industry
Biphenyl Compounds
Glomerulosclerosis
Glomerular Hypertrophy
medicine.disease
Secondary Focal Segmental Glomerulosclerosis
Kidney Transplantation
Proteinuria
Diabetes Mellitus, Type 1
Endocrinology
Benzimidazoles
business
Angiotensin II Type 1 Receptor Blockers
Glomerular hyperfiltration
Subjects
Details
- ISSN :
- 13990012 and 09020063
- Volume :
- 20
- Database :
- OpenAIRE
- Journal :
- Clinical Transplantation
- Accession number :
- edsair.doi.dedup.....35c5594fcb7178b7976ce8627be82a0a