Renal transplantation in diabetes mellitus

Renal failure is common in patients with diabetes mellitus, and renal transplantation has been used in its treatment. There are indications that the operation may be hazardous in these circumstances, and a report is presented in which careful biochemical monitoring of a diabetic patient undergoing transplantation revealed two episodes of hyperkalaemia which might go some way to explain the hazards of this operation. The relevance of the concept of glucose-induced hyperkalaemia is discussed and it is suggested that intravenous infusion of insulin during and after operation might have decreased the rises in serum potassium. The report emphasises the need for careful biochemical monitoring of diabetics undergoing renal transplantation.