title: The long-term outcomes and costs of diabetes mellitus among renal transplant recipients: tacrolimus versus cyclosporine.
abstract: Anti-rejection regimens for renal transplants have changed dramatically during the past 20 years, but there are few long-term studies relating cost, mortality, or graft failure simultaneously to disease-pharmacotherapy couplets. We analyzed US Renal Data System data on a matched-pair cohort of first, single organ kidney transplants from 1998 through 2002 over up to 5 years following transplantation for patients on tacrolimus or low-dose cyclosporine, stratifying by whether the recipient had pre-existing or new onset diabetes. Kaplan-Meier survival curves show mortality and survival differences associated with diabetes, but no additional incremental effects of immune suppression regimen. Significant cost increases are reported for patients receiving tacrolimus above and beyond the extra costs associated with diabetes.
authors.affiliation: Department of Health Management and Policy, University of New Hampshire, Durham, NH, USA. rsw@unh.edu
authors.forename: Robert S
authors.initials: RS
authors.lastname: Woodward
authors.forename: Marc C
authors.initials: MC
authors.lastname: Flore
authors.forename: Gerardo
authors.initials: G
authors.lastname: Machnicki
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Brennan
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003362:Cost-Benefit Analysis / Q000191:economics / Q000639:trends; D016572:Cyclosporine / Q000191:economics* / Q000627:therapeutic use; D003920:Diabetes Mellitus / Q000188:drug therapy / Q000191:economics* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000191:economics / Q000517:prevention & control; D006801:Humans; D016030:Kidney Transplantation / Q000191:economics* / Q000639:trends; D008297:Male; D008875:Middle Aged; D016559:Tacrolimus / Q000191:economics* / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D016572:Cyclosporine; D016559:Tacrolimus