Kidney transplantation in type 2 diabetic patients: a comparison with matched non-diabetic subjects

Abstract

Patient and graft survival after kidney transplantation was similar in type 2 diabetic and matched non-diabetic subjects, with more amputations occurring in the diabetic group. Thus, at a single-centre level renal transplantation results almost equivalent to those in non-diabetic patients may be achieved in type 2 diabetes mellitus.

Sirolimus-Based Immunosuppression in Kidney Transplantation for Type 2 Diabetic Nephropathy

“…However, starting with Kronson et al [12] , very encouraging results of kidney transplantation in type 2 diabetic patients were recently reported in several studies [6,8,9,13,14] , which have demonstrated a similar graft and patient survival in diabetic and in nondiabetic kidney transplant recipients, despite a slight increase in acute rejection rates in type 2 diabetic recipients [9] . Further supporting kidney transplantation in type 2 diabetic patients is the evidence of an overall improvement in health-related quality of life and in functional performance after kidney transplantation [15] .…”

“…The proportion of type 2 diabetic patients requiring renal replacement therapy has drastically increased over the recent years [1,6,8,9] . In one of the previous studies focusing on the outcome of type 2 diabetic recipients, Hirschl et al [10] reported that, in patients without significant vascular complications, survival after kidney transplantation was better than on hemodialysis.…”

“…This is reflected in their poor survival on dialysis and their rare selection for transplantation [5] . All these cofactors, which makes renal transplantation in patients with type 2 diabetes more challenging than in nondiabetic patients, resulted in a reported worse outcome of kidney transplantation in diabetic recipients than in other patient groups [6] . However, many variables are important for an analysis of patient and graft survival, and the type and intensity of immunosuppression is particularly relevant when analyzing the results of kidney transplantation in these patients.…”

Análise da sobrevida do paciente e do enxerto de diabéticos submetidos a diferentes modalidades de transplante

“…Outra explicação para este resultado pode ser a imunossupressão utilizada. Outros trabalhos realizados em pacientes DM tipo 1 (Rayhill et al, 2000;Reddy et al, 2003) e DM tipo 2 (Boucek et al, 2002) mostram que a principal causa de óbito é a doença cardiovascular. A principal causa de perda do enxerto renal foi óbito com enxerto funcionante.…”

“…A principal causa de perda do enxerto renal foi óbito com enxerto funcionante. Este resultado é semelhante ao revelado em outras publicações da literatura (Kronson et al, 2000;Rayhill et al, 2000;Fresnedo et al, 2002;Boucek et al, 2002).…”