Nephrology Dialysis Transplantation, Vol 13, Issue 11 2899-2904, Copyright © 1998 by Oxford University Press
P Voros, G Farkas, Z Lengyel, R Degi, L Rosivall and L Kammerer
Aim of the study: The prevention of diabetic
nephropathy is as yet an unresolved issue. The aim of our study was to
assess the effects of transplantation of long-term cultured and
cryopreserved fetal pancreas islets on metabolic control and the
development of diabetic nephropathy. Methods: Serum
C-peptide, glucose, HbA1c, insulin requirements, urinary albumin excretion
rate, and blood pressure of 10 insulin-dependent diabetic patients after
transplantation were compared with a group of 27 insulin-dependent diabetic
controls on insulin therapy only during a 10-year follow-up.
Results: In the first year after transplantation mean
insulin requirement decreased from 53.6±2.2 to
35.8±1.2 units. C-peptide levels appeared (0.55±0.08
ng/ml) and remained detectable throughout the follow-up.. Blood glucose and
HbA1c were significantly (P<0.05) lower than in the controls. Mean
albumin excretion rates of the transplant and the control groups during the
follow up were 18.8±8.5 and 11.7±2.0,
16.6±6.6 and 14.0±2.3, 15.0±5.0 and
15.1±2.7, 15.3±7.5 and 20.4±4.2,
19.8±6.2 and 36.7±11.1, 11.7±3.6 and
51.3±14.6, 14.1±4.2 and 71.4±23.1,
22.7±8.6 and 92.0±28.1, 18.0±5.9 and
107.6±35.6, 21.7±11.0 and 101.5±29.2
&mgr;g/min respectively. From the 6th year the difference between the
two groups was significant (P<0.001). In the transplant group
initial mean systolic and diastolic blood pressure values were
132.0±3.3 and 81.5±1.5 mmHg, in the controls
130.4±3.4 and 79.6±1.6 mmHg respectively. Significant
changes (P<0.05) of blood pressure during the follow-up or
differences between the two groups were not observed.
Conclusions: We conclude that fetal islet
transplantation is effective in achieving good long-term diabetes control
and in the prevention of diabetic nephropathy. Key
words: albuminuria; diabetic nephropathy; diabetes mellitus;
diabetes control; fetal pancreas islet transplantation
ORIGINAL ARTICLES
Albuminuria after fetal pancreatic islet transplantation: a 10-year follow-up
Second Department of Medicine, Szent István Hospital, Budapest, Hungary; Department of Surgery, Department of Ophthalmology, Albert Szent-Gyorgyi University, Szeged, Hungary; Department of Pathophysiology, Nephrology Research and Training Centre, Semmelweis Medical University, Budapest, Hungary; Corresponding author at: Szent István Kórház, II Belgyógyászat, Nagyvárad tér 1, Budapest 1096, Hungary
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