Outcome of kidney transplantation in type 1 and type 2 diabetic patients and recipients with posttransplant diabetes mellitus

ABSTRACT

We aimed to assess the effects of different types of diabetes mellitus [DM] on patients receiving living donor kidney allografts. A total of 111 kidney transplant patients with DM and 111 randomly selected kidney transplant recipients without DM were enrolled in the study. The characteristics of the kidney allograft recipients and the allograft and patient outcomes were assessed and compared between 4 groups of kidney recipients without DM and patients with type 1 DM, type 2 DM, and posttransplant DM. Of the 111 patients with DM, 36 [32.4%], 20 [18.0%], and 55 [49.6%] had been diagnosed with type 1 DM, type 2 DM, and posttransplant DM, respectively. Diabetic patients had significantly higher rates of rejection episodes [P = .049] and suffered more frequently from delayed graft function [P = .03] compared to the kidney recipients in the control group. Patient and allograft survival rates were significantly lower in the patients with DM [regardless of their DM type] compared to the nondiabetic patients [P = .03 and P = .04, respectively]. Prominently, type 1 DM had significantly adverse effects on patient and allograft survival. Patients with posttransplant DM had a relatively better patient survival compared to those with type 1 DM and type 2 DM. We found that kidney recipients with DM, especially preexisting DM, had worse patient and graft survival rates compared to the nondiabetics. These findings suggest that kidney transplant patients presenting with any type of DM should be more closely followed