title: Negative impact of underlying non-insulin-dependent diabetes mellitus nephropathy on long-term allograft survival in kidney transplantation: a 10-year analysis from a single center.
abstract: BACKGROUND
  We analyzed the relationship between underlying nephropathy and long-term outcomes in kidney transplant recipients.
  
  
  METHODS
  We retrospectively analyzed data from 678 patients who underwent kidney transplantation (KTx) between 1998 and 2011. Recipients with 13 major nephropathies were evaluated for graft and patient survival, and causes of graft loss.
  
  
  RESULTS
  The best 10-year graft survival rates (100%) were in the patients with autosomal-dominant polycystic kidney disease, preeclampsia, Alport syndrome, and purpura nephritis. The worst rate (50.8%) was in patients with non-insulin-dependent diabetes mellitus nephropathy (NIDDMN; P = .039). Causes of graft-loss in the NIDDM patients included chronic rejection (6 cases), acute rejection (3 cases), infection (2 cases), and cardiovascular event (2 cases). Significant risk factors for graft loss were donor age (P < .01) and NIDDMN (P < .01).
  
  
  CONCLUSIONS
  Underlying NIDDMN before KTx was a significant risk factor for long-term graft function. Immunologic factors and nonimmunologic factors influenced the long-term outcomes in patients with underlying NIDDMN.
authors.affiliation: Department of Surgery B, Tokyo Women's Medical University, Tokyo, Japan. Electronic address: ytomita@shiraishi-hp.jp.
authors.forename: Y
authors.initials: Y
authors.lastname: Tomita
authors.affiliation: Department of Surgery B, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Iwadoh
authors.affiliation: Department of Surgery B, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Kutsunai
authors.affiliation: Department of Surgery B, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: I
authors.initials: I
authors.lastname: Koyama
authors.affiliation: Department of Surgery B, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: I
authors.initials: I
authors.lastname: Nakajima
authors.affiliation: Department of Surgery B, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Fuchinoue
mesh_terms: D064591:Allografts; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D005544:Forecasting; D006084:Graft Rejection / Q000453:epidemiology*; D006085:Graft Survival; D006801:Humans; D007564:Japan / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000601:surgery*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D014019:Tissue Donors