A case control study of renal transplantation in patients with type I diabetes.
A case control study was undertaken comparing the outcome of 208 renal allografts transplanted into diabetic recipients with those transplanted into an appropriately matched group of non-diabetic recipients.  In each group there were 151 cadaver, 21 two-haplotype identical, 35 one-haplotype identical, and one zero-haplotype identical living-related grafts.  For the entire group of diabetics, 1- and 5-year graft survivals were 71.3% and 46%.  Graft survivals for the non-diabetic recipients at 1 and 5 yr were 81.8% and 57.8% (p less than 0.05).  In all patient subgroups divided according to the donor source, the graft and patient survival rates for the non-diabetic recipients exceeded those of the diabetic recipients.  One- and 5-yr diabetic patient survivals were 90% and 70%, and for the non-diabetics they were 97% and 95%, respectively (p less than 0.001).  There were 40 deaths among diabetics and 15 among the non-diabetics.  Cardiovascular disease was the major cause of death in the diabetics, accounting for 40% of the deaths.  In addition, allograft loss due to patient death was a significant cause of graft loss in the diabetic group, 24 grafts (28%).  Seven grafts (10%) were lost due to patient death in the non-diabetic group (p less than 0.05). Post-transplant, diabetic recipients had a greater incidence of stroke, angina, myocardial infarction, peripheral vascular disease, urinary tract infections (p less than 0.01 for each), and wound infections (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
Divisions of Nephrology and Urology, Oregon Health Sciences University, Portland 97291.
J L
JL
Munson
W M
WM
Bennett
J M
JM
Barry
D J
DJ
Norman
D000328:Adult; D016022:Case-Control Studies; D003922:Diabetes Mellitus, Type 1 / Q000601:surgery*; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D007165:Immunosuppression Therapy; D016030:Kidney Transplantation / Q000009:adverse effects / Q000401:mortality*; D008297:Male; D011183:Postoperative Complications; D015996:Survival Rate; D014652:Vascular Diseases / Q000150:complications