title: Outcomes of dialysis and the transplantation options for patients with diabetic end-stage renal disease in Korea.
abstract: The best therapeutic option for diabetic end-stage renal disease (DMESRD) has not been established among living donor kidney transplantation (LDKT), deceased donor kidney transplantation (DDKT), simultaneous pancreas and kidney transplantation (SPK), and dialysis.
  
  
  
  We retrospectively analyzed the outcomes of DMESRD patients at two Korean centers from February 2000 to December 2011.
  
  
  
  Among 674 patients, 295 underwent kidney transplantation (LDKT, 175; DDKT, 72; and SPK, 48), while 379 were still on dialysis. The dialysis group had a higher mortality rate than the transplantation group. From the time after dialysis initiation, LDKT group had a better patient survival rate than DDKT registration group and SPK registration group. From the time after transplantation, LDKT had a better patient survival rate than DDKT; however, there was no significant difference between LDKT and SPK. In SPK, patient survival and kidney or pancreas graft survival rates were not different between types 1 and 2 DMESRD.
  
  
  
  LDKT is better than waiting for SPK/DDKT in DMESRD patients, if a living donor is available, and this conclusion may be unique to Korea where waiting time for SPK is long. SPK can be used in non-obese Asians with type 2 as well as type 1 DMESRD.
authors.affiliation: Transplantation Center, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Hee Jung
authors.initials: HJ
authors.lastname: Jeon
authors.affiliation: Transplantation Center, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Tai Yeon
authors.initials: TY
authors.lastname: Koo
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: Miyeun
authors.initials: M
authors.lastname: Han
authors.affiliation: Transplantation Center, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Ha Jin
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Transplantation Center, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Jong Cheol
authors.initials: JC
authors.lastname: Jeong
authors.affiliation: Department of Surgery, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Hyojun
authors.initials: H
authors.lastname: Park
authors.affiliation: Department of Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: Jongwon
authors.initials: J
authors.lastname: Ha
authors.affiliation: Department of Surgery, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Sung Joo
authors.initials: SJ
authors.lastname: Kim
authors.affiliation: Transplantation Center, Seoul National University Hospital, Seoul, Republic of Korea.|Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: Curie
authors.initials: C
authors.lastname: Ahn
authors.affiliation: Department of Surgery, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Jae Berm
authors.initials: JB
authors.lastname: Park
authors.affiliation: Transplantation Center, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Jaeseok
authors.initials: J
authors.lastname: Yang
mesh_terms: D002102:Cadaver; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000401:mortality*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006084:Graft Rejection / Q000401:mortality*; D006085:Graft Survival; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000401:mortality* / Q000601:surgery; D007677:Kidney Function Tests; D016030:Kidney Transplantation / Q000401:mortality*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation / Q000401:mortality*; D011183:Postoperative Complications; D011379:Prognosis; D006435:Renal Dialysis / Q000401:mortality*; D056910:Republic of Korea; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate
keywords: diabetic nephropathies; dialysis; end-stage renal disease; kidney transplantation; pancreas transplantation