title: Clinical outcome of preemptive kidney transplantation in patients with diabetes mellitus.
abstract: End-stage renal disease (ESRD) caused by diabetic nephropathy is increasing throughout the world. The survival of diabetic patients treated by transplantation has improved nowadays. Although recent studies have demonstrated preemptive kidney transplantation to be associated with better graft survival in CKD patients, the effect of pre-transplantation dialysis on graft outcomes among diabetic ESRD patients is unclear. This analysis summarized our experience with preemptive kidney transplantation in diabetic ESRD patients by retrospectively comparing 70 such patients transplanted between 1995 and 2009. These 70 patients were divided into two groups: 30 patients underwent preemptive and the other 40 transplantation after maintenance hemodialysis or peritoneal dialysis. We compared graft survivals, acute rejection episodes, postoperative complications, and delayed graft function rates. The 10-year patient survival of 100% in the preemptive group was similar to that of the nonpreemptive group (85%, P = .11). But the 10 year graft survival was higher among the preemptive than the nonpreemptive group (100% vs 75%, P = .02). Pre-transplantation modality did not affect graft survival. Therefore, preemptive kidney transplantation should be applied to eligible patients with diabetic ESRD.
authors.affiliation: Department of Internal Medicine, Dong-A University, Busan, Korea. dudrlek@medigate.net
authors.forename: Y K
authors.initials: YK
authors.lastname: Son
authors.forename: J S
authors.initials: JS
authors.lastname: Oh
authors.forename: S M
authors.initials: SM
authors.lastname: Kim
authors.forename: J M
authors.initials: JM
authors.lastname: Jeon
authors.forename: Y H
authors.initials: YH
authors.lastname: Shin
authors.forename: J K
authors.initials: JK
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D051799:Delayed Graft Function / Q000209:etiology; D003928:Diabetic Nephropathies / Q000150:complications / Q000401:mortality / Q000601:surgery*; D018450:Disease Progression; D005260:Female; D006084:Graft Rejection / Q000209:etiology; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects / Q000401:mortality; D007723:Korea; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D010530:Peritoneal Dialysis; D016016:Proportional Hazards Models; D006435:Renal Dialysis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents