Influence of diabetes mellitus on patient and graft survival in recipients of kidney transplantation

Revanur, V.; Jardine, Alan G.; Kingsmore, David; Jaques, BC; Hamilton, David; Jindal, Rahul M.

doi:10.1034/j.1399-0012.2001.150202.x

Cited by 176 publications

(118 citation statements)

References 16 publications

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“…In the present study the corresponding 5-year survival rates were: 80 vs 85% for transplanted patients and 18 vs 30% for dialysis patients. Two other studies also report poorer patient survival rates but similar graft survival rates in transplanted diabetic patients [19,20], whereas other studies have found a similar survival rate in diabetic and non-diabetic patients for up to 5 years after transplantation [21][22][23]. Nevertheless, receiving a renal transplantation was the strongest predictor of survival rate in both diabetic and non-diabetic patients, with a 73% lower mortality risk in transplanted patients compared with patients treated with dialysis, even when correcting for age, sex, calendar time and presence of diabetes.…”

Section: Discussionmentioning

confidence: 88%

Improved survival rate in patients with diabetes and end-stage renal disease in Denmark

et al. 2007

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Aims/hypothesis We investigated the survival rate of Danish diabetic patients with end-stage renal disease (ESRD) between 1990 and 2005 and evaluated possible predictors of survival rate. Materials and methods Data were obtained from the Danish National Register on Dialysis and Transplantation and from the Scandiatransplant database. Survival rates in different patient groups and association with age, sex, calendar time, waiting-list status and renal transplantation were evaluated using a multivariate Cox regression model. Results During the study period 8,421 patients (13% type 1 diabetic, 9% type 2 diabetic and 78% non-diabetic) started renal replacement therapy. The overall survival rate improved by 15% per five calendar years (hazard ratio [HR]=0.85, 95% CI: 0.81-0.88). The percentage of patients within each group who received renal transplantation was: type 1 diabetic: 26%, type 2 diabetic: 5%, non-diabetic: 24%. The survival rate of transplanted patients with diabetes mellitus (types 1 and 2) compared with nondiabetic patients at 1 year was: 95 vs 93%, at 5 years: 80 vs 85% and at 10 years: 52 vs 71%. Among diabetic patients survival rate was better in transplanted than in waiting-list patients (HR =0.21, 95% CI 0.13-0.34), whereas the survival rate in waiting-list patients seemed to be superior to the survival rate among non-transplantation candidates (HR=0.75, 95% CI 0.53-0.1.02, p=0.07). Conclusions/interpretation The survival rate of diabetic patients with ESRD has improved during the last 15 years. Although some selection bias may exist, significantly improved survival rate was observed among transplanted patients compared with dialysis patients on the waiting-list for transplantation. Renal transplantation should therefore be offered to diabetic patients with ESRD whenever possible.

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Section: Discussionmentioning

confidence: 88%

Improved survival rate in patients with diabetes and end-stage renal disease in Denmark

et al. 2007

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“…The proportion of RTR-PD patients surviving with a functioning graft was numerically higher for belatacept versus cyclosporine at 1 year, particularly for the LI regimen, whereas similar composite patient/graft survival was observed in the belatacept and cyclosporine arms in the overall ITT population (16,17). Retrospective studies involving RTR-PD show 1-year patient and graft-survival rates in the approximate range of 85% to 95% (5,6,20) and 80% to 90% (4 -6), respectively. In this study, the 1-year patient survival rates were at the higher end of the range previously reported (5,6,20), and 1-year survival rates were slightly higher for belatacept LI-treated patients compared with cyclosporine-treated patients.…”

Section: Discussionmentioning

confidence: 99%

Belatacept-versus Cyclosporine-Based Immunosuppression in Renal Transplant Recipients with Pre-existing Diabetes

Rostaing¹,

Neumayer

Reyes‐Acevedo³

et al. 2011

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives Renal transplant recipients with pre-existing diabetes (PD) have reduced graft survival and increased risk of mortality and ischemic heart disease compared with nondiabetic transplant recipients. To assess the effect of belatacept in this high-risk group, we evaluated outcomes of the subpopulation with PD from previously published BENEFIT and BENEFIT-EXT trials. ConclusionsIn post hoc analysis of patients with PD, patient/graft survival and renal function at 12 months were numerically higher with belatacept versus cyclosporine, but not statistically significant. Further study is necessary to confirm the benefits belatacept may provide in these patients.

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“…28,29 Thus, most programs offer organs to patients infected with hepatitis C virus (HCV), patients with diabetes, older patients (up to a point), and black patients, despite clear evidence that post-transplantation survival is diminished in each of these groups. [30][31][32][33][34][35][36][37][38] On ethical grounds alone, there is no justification for providing organs to these groups of patients but not to patients infected with HIV.…”

Section: Ethical Considerationsmentioning

confidence: 99%

Solid-Organ Transplantation in HIV-Infected Patients

Halpern

Ubel²,

Caplan³

2002

N Engl J Med

128

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Influence of diabetes mellitus on patient and graft survival in recipients of kidney transplantation

Abstract: Patient survival, but not graft survival, was adversely affected by both pre-existing diabetes and by PTDM, particularly in those with an age less than 55 yr.

Cited by 176 publications

References 16 publications

Improved survival rate in patients with diabetes and end-stage renal disease in Denmark

Improved survival rate in patients with diabetes and end-stage renal disease in Denmark

Belatacept-versus Cyclosporine-Based Immunosuppression in Renal Transplant Recipients with Pre-existing Diabetes

Solid-Organ Transplantation in HIV-Infected Patients

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