In Japan,
diabetic nephropathy accounted for 16,225 (43.7%) of the 38,473 patients who began
hemodialysis in 2010 and the number increases year by year. In 1991, we started a
kidney transplantation program for patients with
diabetic nephropathy in our institution, and the ratio of patients who underwent
kidney transplantation for
diabetic nephropathy traces the course of increase. Among the 516 patients who underwent primary
kidney transplantation in our institution from January 1991 to February 2013, we divided them into 2 groups. One group was the
diabetes mellitus (DM) group, which included patients with primary disease of
diabetic nephropathy, and the other group was the non-DM group. The DM group included 50 patients, and in our institution the ratio traces the course to increase. There was no significant difference for the 1-year and 5-year patient survival rates and graft survival rates between the DM group and the non-DM group. Moreover, the rate of acute rejection in the 2 groups was not significantly different. Furthermore, when we investigated the causes of death in the 2 groups, there was no significant difference with the mortality of cases due to heart
vascular disease in the DM group and the non-DM group. Also, no case in which the graft lost function due to recurrence of
diabetic nephropathy was observed. Although the early outcome of
kidney transplantation for
diabetic nephropathy in our institution did not have inferiority in comparison with
kidney transplantation for the other primary disease, we think that careful diabetic control after
kidney transplantation is required for long-term outcome.