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2016, Number 1

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RCAN 2016; 26 (1)

Impact of Type 2 Diabetes upon evolution of kidney graft

Borroto DG, Prado E, Barcelo AM

Language: Spanish
References: 46
Page: 37-55
PDF size: 382.44 Kb.


ABSTRACT

Rationale: Type 2 Diabetes (T2D) might be cause as well as consequence of renal transplantation (RT). Evolution of kidney graft might be unfavorable in the diabetic chronic kidney patient when compared with patients transplanted for other reasons. Objective: To compare the clinical evolution of RT according with the T2D condition: Pre-existing vs. Developed de novo. Study design: Retrospective. Study serie: Chronic kidney patients with ages › 15 years receiving a RT at the “Hermanos Ameijeiras” Surgical Clinial Hospital (Havana City, Cuba), in whom graft survived the first year, from the inception of RT program up to December 31st, 2013. Third transplants and combined transplants were excluded. Material and method: Demographic and clinical data, T2D condition, complications during the first year of life of the graft, and its current status, were recovered from transplanted patients. Non-diabetic, transplanted patients were included as controls. Results: According with T2D condition, study serie behaved as follows: Group I: Pre-existent Diabetics: 7% vs. Group II: Post-transplant Diabetics: 15%. Patients groups were similar regarding sex, immunosuppressive treatment, and graft source. Transplanted diabetic (Groups I + II) were older than Non-Diabetic patients (Group III). Causes for loss of the kidney graft were similar across all subgroups: death of the patient and chronic dysfunction of the graft. Likewise, causes for mortality were equally presented in the three subgroups: infections and cardiovascular diseases. Blood hypertension, dyslipidemia, obesity, hyperuricemia, and Metabolic Syndrome (MS) were more frequent among diabetics. Pre-existing diabetics showed comparatively diminished rates of kidney graft function after one year, as well as of patient’s first-year survival. Conclusions: Patients arriving to Chronic Kidney Disease (CKD) because of diabetic nephropathy might have reduced options for transplantation. Evolution of the pre-existing diabetic CKD patient might be lower than that of those developing Diabetes after grafting.


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