title: The effect of medical therapy and islet cell transplantation on diabetic nephropathy: an interim report.
abstract: BACKGROUND
  The effect of islet cell transplantation (ICT) on renal function in type 1 diabetes is uncertain and some recent studies report a significant decline in estimated glomerular filtration rate (GFR) and worsening of albuminuria.
  
  
  METHODS
  We are conducting a prospective crossover study comparing medical treatment with islet transplantation on the progression of diabetic complications, including renal function. The primary endpoint is change in GFR measured by Tc-diethylenetriaminepentaacetate with secondary endpoints including estimated GFR and albumin excretion.
  
  
  RESULTS
  We have followed 21 patients after islet transplantation a median of 29 months (range 13-45) and compared their results with medically treated patients followed a median 29.5 months (range 13-56). There is no difference in the rate of decline in measured GFR between medically treated patients (-0.35+/-0.89; 95% CI: -0.57 to -0.13 mL/min/month/1.73 m) and those after ICT (-0.31+/-1.18; 95% CI: -0.61 to -0.01) and neither is significantly different from that expected for the general population. The rate of decline in our estimated GFR results is lower than that reported in other studies and we did not find any worsening of albuminuria.
  
  
  CONCLUSIONS
  We do not find evidence of worsening of renal function after islet transplantation compared with medically treated patients.
authors.affiliation: Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Fung
authors.forename: Garth L
authors.initials: GL
authors.lastname: Warnock
authors.forename: Ziliang
authors.initials: Z
authors.lastname: Ao
authors.forename: Paul
authors.initials: P
authors.lastname: Keown
authors.forename: Mark
authors.initials: M
authors.lastname: Meloche
authors.forename: R Jean
authors.initials: RJ
authors.lastname: Shapiro
authors.forename: Stephen
authors.initials: S
authors.lastname: Ho
authors.forename: Dan
authors.initials: D
authors.lastname: Worsley
authors.forename: Graydon S
authors.initials: GS
authors.lastname: Meneilly
authors.forename: Khalid
authors.initials: K
authors.lastname: Al Ghofaili
authors.forename: Sharon E
authors.initials: SE
authors.lastname: Kozak
authors.forename: Suet On
authors.initials: SO
authors.lastname: Tong
authors.forename: Mary
authors.initials: M
authors.lastname: Trinh
authors.forename: Lorraine
authors.initials: L
authors.lastname: Blackburn
authors.forename: Robert M
authors.initials: RM
authors.lastname: Kozak
authors.forename: Blake A
authors.initials: BA
authors.lastname: Fensom
authors.forename: David M
authors.initials: DM
authors.lastname: Thompson
mesh_terms: D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000503:physiopathology; D001786:Blood Glucose / Q000378:metabolism; D015331:Cohort Studies; D018592:Cross-Over Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy* / Q000601:surgery* / Q000652:urine; D003928:Diabetic Nephropathies / Q000503:physiopathology*; D018450:Disease Progression; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D016381:Islets of Langerhans Transplantation; D007668:Kidney / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents