Pre-existing diabetes significantly increases the risk of graft failure and mortality following renal transplantation. Clin Transplant 2013;27(2):274-82
Date
02/07/2013Pubmed ID
23383719DOI
10.1111/ctr.12080Scopus ID
2-s2.0-84876073307 (requires institutional sign-in at Scopus site) 36 CitationsAbstract
The aim of this study was to examine the impact of pre-existing diabetes mellitus (DM) on acute rejection, graft loss, and mortality following kidney transplant and whether glycemic control or cardiovascular disease (CVD) risk control with medications influenced outcomes. This was a cohort study of 1002 renal transplants conducted between 2000 and 2008. Patients were included if they received a kidney transplant within the allotted time and were at least 18 yr of age. Cox regression was used to assess acute rejection, graft failure, or death controlling for relevant sociodemographic, clinical, and post-transplant variables. Five-yr patient survival (83% vs. 93%, p < 0.001) and graft survival (74% vs. 79%, p = 0.005) were significantly lower in patients with pre-existing DM. Sequential Cox regression models demonstrated that pre-existing DM was consistently associated with a higher risk of death (HR 2.3-3.0, p < 0.01) and graft failure (HR 1.5-1.8, p < 0.04) in all models except after adjusting for CVD medication use (HR 1.9, p = 0.174 and HR 1.5, p = 0.210, respectively). These data suggest pre-existing DM is a significant risk factor for graft failure and death following renal transplantation and aggressive CVD risk reduction with medications may be an important strategy to reduce mortality and graft failure.
Author List
Taber DJ, Meadows HB, Pilch NA, Chavin KD, Baliga PK, Egede LEAuthor
Leonard E. Egede MD Center Director, Chief, Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentAdult
Aged
Aged, 80 and over
Cardiovascular Diseases
Diabetes Complications
Diabetes Mellitus
Female
Follow-Up Studies
Graft Rejection
Graft Survival
Humans
Kidney Failure, Chronic
Kidney Transplantation
Male
Middle Aged
Preoperative Period
Retrospective Studies
Risk Factors
Survival Analysis
Treatment Outcome
Young Adult
