title: Kidney transplantation in type 2 diabetic patients: a matched survival analysis.
abstract: BACKGROUND
  Diabetes mellitus (DM) is the most prevalent cause of kidney failure. Some concerns have been raised about the kidney transplantation (KT) results in diabetic patients. Therefore, we compared outcomes between diabetic and non-diabetic KT patients.
  
  
  METHODS
  We included all KT performed in type 2 diabetic patients in our center from July 1983 to December 2009 with graft survivals beyond 3 months. Nondiabetic controls were individually matched with diabetic patients with respect to gender, age, year of transplantation, number of donor HLA mismatches, and dialysis vintage. The two groups were compared concerning patient and graft survivals, delayed graft function (DGF), and prevalence of acute rejection episodes (ARE).
  
  
  RESULTS
  The 62 diabetic and 62 nondiabetic patients had a mean follow-up after KT of 102 ± 64 months. Diabetic patients and controls were similar for the matched variables. Death censored graft survivals of diabetics versus nondiabetics were 70% and 83% at 5 years and 54% and 71% at 10 years, respectively (P = .13). Patient survivals at 5 and 10 years were 69% and 50% for diabetic versus 96% and 84% for nondiabetic patients, respectively (P < .001). The prevalence of ARE and DGF did not differ (chi-squared test, P = .12). Multivariate Cox's proportional hazards analysis revealed DM (hazard ratio [HR] 7.72; P = .001) and viral hepatitis (HR = 4.18; P = .02) to correlate with reduced patient survival.
  
  
  CONCLUSIONS
  Survival of diabetic patients after KT was reduced but death-censored graft outcomes were similar compared with matched nondiabetic patients. Concerns about graft survival should not prevent KT for diabetic patients with kidney failure.
authors.affiliation: Department of Nephrology, Centro Hospitalar do Porto, Porto, Portugal. acrisbraga@gmail.com
authors.forename: A
authors.initials: A
authors.lastname: Rocha
authors.forename: J
authors.initials: J
authors.lastname: Malheiro
authors.forename: L S
authors.initials: LS
authors.lastname: Martins
authors.forename: I
authors.initials: I
authors.lastname: Fonseca
authors.forename: L
authors.initials: L
authors.lastname: Dias
authors.forename: S
authors.initials: S
authors.lastname: Pedroso
authors.forename: M
authors.initials: M
authors.lastname: Almeida
authors.forename: A C
authors.initials: AC
authors.lastname: Henriques
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D016009:Chi-Square Distribution; D051799:Delayed Graft Function / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000401:mortality; D003928:Diabetic Nephropathies / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology; D006085:Graft Survival; D006801:Humans; D053208:Kaplan-Meier Estimate; D016030:Kidney Transplantation / Q000009:adverse effects / Q000401:mortality; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D015999:Multivariate Analysis; D018579:Patient Selection; D011174:Portugal / Q000453:epidemiology; D015995:Prevalence; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult