Clinical outcome of kidney transplantation in patients with diabetic nephropathy |
Young-Ki Son, Joon-Seok Oh, Hyae-Ju Oh, Yong-Hun Shin, Joong-Kyung Kim |
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당뇨병성 말기 신부전 환자에서 시행한 신장이식의 단일센터 임상성적 |
손영기·오준석·오혜주·신용훈·김중경, Joon-Seok Oh, Hyae-Ju Oh, Yong-Hun Shin, Joong-Kyung Kim |
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Abstract |
Background/Aims Diabetic nephropathy is a growing cause of end-stage renal failure, and renal transplantation is considered
the best option for survival in patients who experience such renal failure. Patients with diabetes are older and frequently have comorbidity,
and only a minority of these patients is considered for renal transplantation. The survival rate of patients having diabetes
treated with transplantation has improved, although the long-term prognosis has not been determined. This study examined the clinical
outcome of renal transplantation in patients having diabetes compared to that in nondiabetic patients.
Methods We compared diabetic (n=70) and nondiabetic (n=355) groups of patients for whom medical records were available for
more than 3 months at our hospital from March 1998 to August 2008.
Results The recipients were significantly older in the diabetic group (50.6±10.5 vs. 39.8±10.8 years), while donor age was significantly
younger in that group (33.2±9.0 vs. 37.5±1.3 years). Cardiovascular events occurring after transplantation were more frequent
in the diabetic group (11/70 vs. 10/355). Kaplan-Meier curves for cumulative survival of the renal allograft and patient survival
revealed no difference between the two groups. The allograft survival rate in the diabetic group was 100% at 5 years and 79%
at 10 years posttransplantation. In the nondiabetic group, the renal allograft survival rate was 98% at 5 years and 75% at 10 years.
The patient survival rates did not differ significantly: 100% vs. 99% at 5 years and 91% vs. 91% at 10 years for the diabetic and nondiabetic
groups, respectively.
Conclusions In our study, the long-term survival of renal transplantation in patients with diabetes equaled that of nondiabetic
patients. Graft survival was also comparable between the two groups. Therefore, kidney transplantation may be another therapeutic
option for end-stage diabetic nephropathy. (Korean J Med 77:321-327, 2009) |
Key Words:
Diabetic nephropathy; Graft survival; Patient survival; Kidney transplantation |
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