Abstract: Ｏｂｊｅｃｔｉｖｅ：To explore the clinicopathological features and prognosis of posttransplant diabetic nephropathy (DN).
Ｍｅｔｈｏｄｏｌｏｇｙ：Patients with allograft biopsyproven DN from December 2009 to July 2021 were reviewed retrospectively.
Ｒｅｓｕｌｔｓ：In 13 patients who were all male, 4 recipients had the history of diabetes mellitus (DM) before transplantation and 9 recipients developed posttransplantation DM (PTDM). At the time of allograft biopsy, the mean age of the 13 patients was 466 years, and the median levels of serum creatinine (SCr) and proteinuria were 1441 (902, 1945) μmol／L and 14 (05, 38) g／24h, respectively. PTDM was diagnosed at a median time of 246 months after transplantation. Allograft biopsy and histologic diagnosis of posttransplant DN was made, on average, 716 months after PTDM. Of 13 cases showing mesangial matrix expansion and glomerular basement membrane thickening, only 3 recipients existed KW nodules. Eleven patients combined with nondiabetic kidney disease (NDRD), including IgA nephropathy (IgAN) in 5, membranous nephropathy (MN) in 2, focal segmental glomerulosclerosis (FSGS) and chronic graft glomerulopathy (TG) in 1 case each. Two recipients accompanied with TG in repeat allograft biopsy. Among 11 patients with available followup information, the mean time from last followup to transplantation were 1503 months, and the median time from last followup to allograft biopsy were 170 months. Recipients complicated with IgAN or MN had a relatively stable SCr, while 2 of 4 cases with TG or FSGS developed allograft failure, and the SCr doubled in the rest of 2 cases.
Ｃｏｎｃｌｕｓｉｏｎ：Patients with posttransplant DN mainly presented with moderate albuminuria and allograft dysfunction. Histologically, typical KW nodules were not always present, and the inclunce of coexisting NDRD was high.