Korean J Intern Med.  2018 Mar;33(2):356-366. 10.3904/kjim.2016.067.

Outcomes of living donor kidney transplantation in diabetic patients: age and sex matched comparison with non-diabetic patients

• Baek CH
• Kim H
• Baek SD
• Jang M
• Kim W
• Yang WS
• Han DJ
• Park SK

• KMID: 2411548
• DOI: http://doi.org/10.3904/kjim.2016.067

Abstract

BACKGROUND/AIMS
Kidney transplantation (KT) reportedly provides a significant survival advantage over dialysis in diabetic patients. However, KT outcome in diabetic patients compared with that in non-diabetic patients remains controversial. In addition, owing to recent improvements in the outcomes of KT and management of cardiovascular diseases, it is necessary to analyze outcomes of recently performed KT in diabetic patients.
METHODS
We reviewed all diabetic patients who received living donor KT between January 2008 and December 2011. Each patient was age- and sex-matched with two non-diabetic patients who received living donor KT during the same period. The outcomes of living donor KT were compared between diabetic and non-diabetic patients.
RESULTS
Among 887 patients, 89 diabetic patients were compared with 178 non-diabetic patients. The incidence of acute rejection was not different between the diabetic and non-diabetic patients. Urinary tract infection and other infections as well as cardiovascular events occurred more frequently in diabetic patients. However, diabetes, cardiovascular disease, and infection were not significant risk factors of graft failure. Late rejection (acute rejection after 1 year of transplantation) was the most important risk factor for graft failure after adjusting for diabetes mellitus (DM), human leukocyte antigen mismatch, rejection and infection (hazard ratio, 56.082; 95% confidence interval, 7.169 to 438.702; p < 0.001). Mortality was not significantly different between diabetic and non-diabetic patients (0 vs. 2, p = 0.344 by log-rank test).
CONCLUSIONS
End-stage renal disease patients with DM had favorable outcomes with living donor kidney transplantation.

Keyword

Kidney transplantation; Diabetes mellitus; Living donors

MeSH Terms

Cardiovascular Diseases
Diabetes Mellitus
Dialysis
Humans
Incidence
Kidney Failure, Chronic
Kidney Transplantation*
Kidney*
Leukocytes
Living Donors*
Mortality
Risk Factors
Transplants
Urinary Tract Infections