Impact of diabetes mellitus on kidney transplant recipients in Spain
| Autor: | Beatriz Bayés Genís, Javier García Perez, Domingo Hernández, Manuel Rivero Sanchez, José Manuel González-Posada |
|---|---|
| Rok vydání: | 2004 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Gastroenterology Internal medicine Diabetes mellitus medicine Diabetes Mellitus Humans Diabetic Nephropathies Survival rate Kidney transplantation Retrospective Studies Transplantation business.industry Incidence (epidemiology) Graft Survival Retrospective cohort study Middle Aged medicine.disease Kidney Transplantation Surgery Survival Rate Nephrology Spain Female Hemodialysis business Kidney disease |
| Zdroj: | Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association. 19 |
| ISSN: | 0931-0509 |
| Popis: | The increasing prevalence of pre-existing diabetes mellitus (DM) and especially the incidence of post-transplant diabetes mellitus (PTDM) is a disturbing tendency with far-reaching health and cost implications. We assessed the factors associated with PTDM and the impact of either condition on death-censored graft and patient survival.We studied 3365 adult kidney allograft recipients transplanted in 1990, 1994 and 1998, whose graft was functioning after 1 year of follow-up. Three groups were considered: Group I (DM; N = 156), Group II (PTDM; N = 251) and Group III (non-diabetic; N = 2958).Group I patients had been dialysed for shorter periods and received angiotensin-converting enzyme inhibitor (ACEI) or angiotensin-receptor blockers (ARB) therapy more frequently during follow-up than the other groups (P0.001). Mean age, body weight and body mass index (BMI) were greater in Group II patients than the other groups (P0.001). Group II showed lower rejection rates than Group III (P0.01). Risk factors for developing PTDM were recipient age60 years (OR = 2.24; P0.001), female recipient (OR = 1.5; P0.005), recipient weight65 kg (OR = 1.77; P0.002), BMI25 kg/m(2) (OR = 1.6; P0.04) or30 kg/m(2) (OR = 2.92; P0.005), and tacrolimus-based therapy (OR = 1.48; P0.05). Of note, the use of Sandimmune vs Neoral had a protective effect (OR = 0.7; P0.01). Using Cox's proportional hazards analysis, DM correlated with reduced death-censored graft survival (RR = 1.68; 95% CI = 1.14-2.47; P0.008), while PTDM correlated with reduced patient survival (RR = 1.55; 95% CI = 1.05-2.27; P0.02).One year after transplantation, DM was associated with a decrease in death-censored graft survival, while PTDM was an independent negative predictor of patient survival after kidney transplantation. New strategies to improve outcome are needed. |
| Databáze: | OpenAIRE |
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