Impact of smoking on progression of vascular diseases and patient survival in type-1 diabetic patients after simultaneous kidney-pancreas transplantation in a single centre.
We evaluated the impact of smoking on the progression of macro-angiopathy as well as patient and graft survival in 35 type-1 diabetic patients with simultaneous kidney-pancreas transplantation (SKPT). According to their smoking history, the patients were divided into smokers (n = 12) and nonsmokers (n = 23). Mean observation period was 80 (12-168) vs. 84 (12-228) months. The prevalence of vascular diseases as well as the incidence of vascular complications during the observation period was evaluated in each group. Graft- and patient survival were calculated. The prevalence of all vascular diseases was higher in the smokers with prior SKPT at the start as also at the end of study; however, the differences were not significant. In addition, the incidence of vascular complications (stroke, myocardial infarction and amputation) during the follow-up period was higher in the smoking group. Taking all vascular complications together (events/patient/year) the difference was significant (0.105 vs. 0.066, P < 0.05). One- and 5-year patient survival was 100% and 75% for smokers vs. 100% and 91% for nonsmokers. One- and 5-year pancreas graft survival at the same time was 100% and 75% in living smokers as well as 100% and 83% in the nonsmokers: We conclude that smoking after SKPT is associated with a progression of macro-angiopathy. Additionally, mortality after SKPT tends to be higher in smoking patients.
Biesenbach
Georg
G
Second Department of Medicine, Section Nephrology, General Hospital, Linz, Austria. georg.biesenbach@akh.linz.at
Biesenbach
Peter
P
Bodlaj
Gerd
G
Pieringer
Herwig
H
Schmekal
Bernhard
B
Janko
Otmar
O
Margreiter
Raimund
R
D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000401:mortality* / Q000601:surgery; D003925:Diabetic Angiopathies / Q000209:etiology / Q000503:physiopathology* / Q000601:surgery; D018450:Disease Progression; D005260:Female; D006085:Graft Survival; D006801:Humans; D007674:Kidney Diseases / Q000209:etiology / Q000601:surgery; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation; D012907:Smoking / Q000009:adverse effects*; D015996:Survival Rate