title: Renal transplant among type 1 and type 2 diabetes patients in Spain: A population-based study from 2002 to 2013.
abstract: BACKGROUND
  To describe trends in the rates and short-term outcomes of renal transplants (RTx) among patients with or without diabetes in Spain (2002-2013).
  
  
  METHODS
  We used national hospital discharge data to select all hospital admissions for RTx. We divided the study period into four three-year periods. Rates were calculated stratified by diabetes status: type 1 diabetes (T1DM), type 2 diabetes (T2DM) and no-diabetes. We analyzed Charlson comorbidity index (CCI), post-transplant infections, in-hospital complications of RTx, rejection, in-hospital mortality and length of hospital stay.
  
  
  RESULTS
  We identified 25,542 RTx. Rates of RTx increased significantly in T2DM patients over time (from 9.3 cases/100,000 in 2002/2004 to 13.3 cases/100,000 in 2011/2013), with higher rates among people with T2DM for all time periods. T2DM patients were older and had higher CCI values than T1DM and non-diabetic patients (CCI≥1, 31.4%, 20.4% and 21.5%, respectively; P<0.05). Time trend analyses showed significant increases in infections, RTx-associated complications and rejection for all groups (all P values<0.05). Infection rates were greater in people with T2DM (20.8%) and T1DM (23.5%) than in non-diabetic people (18.7%; P<0.05). Time trend analyses (2002-2013) showed significant decreases in mortality during admission for RTx (OR 0.75, 95% CI 0.68-0.83). Diabetes was not associated with a higher in-hospital mortality (OR: 1.20, 95% CI 0.92-1.55).
  
  
  CONCLUSIONS
  RTx rates were higher and increased over time at a higher rate among T2DM patients. Mortality decreased over time in all groups. Diabetes does not predict mortality during admission for RTx.
  
  
  BACKGROUND
  Instituto Salud Carlos III and URJC-Banco Santander.
authors: Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Avenida de Atenas s/n. 28292, Alcorcón, Madrid, Spain. Electronic address: ana.lopez@urjc.es.
authors: Ana
authors: A
authors: López-de-Andrés
authors: Internal Medicine Department, Hospital General Universitario Gregorio Marañón, 46, Doctor Esquerdo, 28007 Madrid, Spain. Electronic address: josemaria.demiguel@salud.madrid.org.
authors: José M
authors: JM
authors: de Miguel-Yanes
authors: Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Avenida de Atenas s/n. 28292, Alcorcón, Madrid, Spain. Electronic address: valentin.hernandez@urjc.es.
authors: Valentín
authors: V
authors: Hernández-Barrera
authors: Internal Medicine Department, Hospital Universitario Clínico San Carlos, Profesor Martín Lagos, s/n. 28040, Madrid, Spain. Electronic address: manuel.mendez@salud.madrid.org.
authors: Manuel
authors: M
authors: Méndez-Bailón
authors: Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Avenida de Atenas s/n. 28292, Alcorcón, Madrid, Spain. Electronic address: mngnps@yahoo.com.
authors: Montserrat
authors: M
authors: González-Pascual
authors: Respiratory Care Department, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, 46, Doctor Esquerdo, 28007 Madrid, Spain. Electronic address: javier.miguel@salud.madrid.org.
authors: Javier
authors: J
authors: de Miguel-Díez
authors: Dirección Técnica de Docencia e Investigación, Gerencia Atención Primaria, 24, Espronceda, 28003 Madrid, Spain. Electronic address: miguel.salinero@salud.madrid.org.
authors: Miguel A
authors: MA
authors: Salinero-Fort
authors: Health Security Agency Ministry of Health, Social Services and Equality, 56, Alcalá, 28071 Madrid, Spain. Electronic address: pereznapo@gmail.com.
authors: Napoleón
authors: N
authors: Pérez-Farinós
authors: Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Avenida de Atenas s/n. 28292, Alcorcón, Madrid, Spain. Electronic address: isabel.jimenez@urjc.es.
authors: Isabel
authors: I
authors: Jiménez-Trujillo
authors: Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Avenida de Atenas s/n. 28292, Alcorcón, Madrid, Spain. Electronic address: rodrigo.jimenez@urjc.es.
authors: Rodrigo
authors: R
authors: Jiménez-García
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003928:Diabetic Nephropathies / Q000209:etiology / Q000601:surgery*; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology*; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000601:surgery*; D016030:Kidney Transplantation / Q000639:trends*; D007902:Length of Stay / Q000639:trends; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D013530:Surgical Wound Infection / Q000453:epidemiology*; D055815:Young Adult
keywords: In-hospital mortality; Renal transplant; Type 1 diabetes; Type 2 diabetes