Patients with diabetes at time of kidney allograft loss may have lower survival
Click Here to Manage Email Alerts
Key takeaways:
- During follow-up, 35% of patients died, according to the findings.
- Overall, 32% of deaths were linked to cardiovascular disease, 20% to dialysis withdrawal and 15% to infection.
Patients who have diabetes at the time of kidney allograft loss may have a lower chance of survival compared with patients without diabetes, according to study results.
“In patients commencing dialysis, patients with diabetes have up to a 40% greater risk of mortality and up to a 63% greater risk of cardiovascular disease [CVD] mortality, compared to those without diabetes,” Amali Samarasinghe, of the Sir Charles Gairdner Hospital in Australia, wrote with colleagues. “In kidney transplant recipients, those with pre-transplant diabetes or who have developed post-transplant diabetes (PTDM) have a significant survival disadvantage, with the dominant cause of death attributed to CVD.”
Researchers collected data from the Australia and New Zealand Dialysis and Transplant registry to explore the relationship between diabetic status and risk of all-cause and cause-specific mortality on dialysis. Overall, 3,782 adults aged18 years and older with failed first-time kidney allografts transplanted between 2000 and 2020 were included.
Patients were categorized into groups as those with pre-transplant diabetes mellitus and those with post-transplant diabetes mellitus and followed for a median of 2.7 years.
Overall, 539 patients had pre-transplant diabetes and 390 patients had developed post-transplant diabetes mellitus. During follow-up, 35% of patients died, with 32% of deaths linked to cardiovascular disease, 20% to dialysis withdrawal and 15% to infection, according to the results.
“Our binational study demonstrated that patients with any form of diabetes at the time of kidney allograft loss who commenced or had reinitiated on dialysis had poorer survival, predominantly driven by an excess of infection and dialysis withdrawal-related deaths,” the researchers wrote.
Collapse
Click Here to Manage Email Alerts