Are diabetic patients in danger at renal transplantation? An invasive perioperative study.
It is assumed that diabetic patients with uraemia have more complications at renal transplantation than those who are not diabetic. We compared the preoperative ECGs, and invasive perioperative haemodynamic and oxygenation parameters in 15 diabetic and 15 non-diabetic uraemic patients undergoing renal transplantation. The number of patients with increased QT dispersion in the ECG was higher in diabetic than in non-diabetic patients (P<0.05). Before anaesthesia, heart rate and mean arterial pressure were higher (P<0.05) in the diabetic than in the non-diabetic group. After preanaesthetic volume loading all patients showed a hyperdynamic circulation, which subsided during anaesthesia. However, stroke volume index remained unchanged. Four patients in the diabetic group and six in the non-diabetic group needed additional oxygen therapy after surgery. No cardiac dysrhythmias were noted. However, the increased QT dispersion in diabetic patients calls for an adequate perioperative ECG monitoring for dysrhythmias. The diabetic and non-diabetic uraemic patients performed equally well at renal transplantation. In conclusion, renal transplantation for diabetics is justified.
Norio
K
K
Department of Anaesthesia, Helsinki University Central Hospital, Helsinki, Finland.
Mäkisalo
H
H
Isoniemi
H
H
Groop
P H
PH
Pere
P
P
Lindgren
L
L
D000328:Adult; D003928:Diabetic Nephropathies / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D004562:Electrocardiography; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D011183:Postoperative Complications; D012307:Risk Factors; D014511:Uremia / Q000150:complications
D010100:Oxygen