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Transplantation for diabetic nephropathy
Abstract:
The results of renal transplantation for end-stage diabetic nephropathy in 17 patients--11 receiving cadaver (CD) grafts and 6 related living donor (RLD) grafts--are reported. The transplants were rejected in 5 cases, in 4 acutely, and these patients were returned to haemodialysis; 3 of them subsequently died. One patient died of heart failure, but the graft was still functioning. The remaining 11 patients enjoy good renal function. The outcome was superior to results on dialysis, particularly for RLD grafts, and was comparable to results of transplantation for non-diabetic renal failure. Visual acuity tended to stabilize or improve after transplantation, but peripheral vascular disease progressed. Blood glucose control was suboptimal and requires more attention. Lipoproteins did not differ from those in non-diabetic patients. Renal transplantation is feasible and probably the preferred method of treatment for end-stage diabetic nephropathy.
Insights
Renal transplantation for diabetic nephropathy offers better outcomes than dialysis, especially with related living donors. While vision may improve, careful blood glucose management is crucial post-transplant.
Area of Science:
- Nephrology
- Transplantation immunology
- Diabetology
Background:
- End-stage diabetic nephropathy is a leading cause of end-stage renal disease (ESRD).
- Renal transplantation is a potential treatment option for ESRD in diabetic patients.
- Outcomes of renal transplantation in diabetic patients require further evaluation.
Purpose of the Study:
- To report the outcomes of renal transplantation in patients with end-stage diabetic nephropathy.
- To compare the results of renal transplantation with dialysis and transplantation for non-diabetic renal failure.
Main Methods:
- Retrospective analysis of 17 patients with end-stage diabetic nephropathy who underwent renal transplantation.
- Graft types included cadaver (CD) and related living donor (RLD) grafts.
- Patient and graft survival, renal function, visual acuity, peripheral vascular disease, and blood glucose control were assessed.
Main Results:
- 11 out of 17 patients had good renal function post-transplantation.
- Graft rejection occurred in 5 cases (4 acute), with 3 of these patients subsequently dying.
- One patient died of heart failure despite functioning graft; visual acuity stabilized or improved, but peripheral vascular disease progressed.
Conclusions:
- Renal transplantation is a feasible and potentially preferred treatment for end-stage diabetic nephropathy.
- Outcomes were superior to dialysis, particularly for RLD grafts.
- Suboptimal blood glucose control necessitates closer attention post-transplantation.