Renal transplantation in patients with type 2 diabetes mellitus

The proportion of type 2 diabetic patients considered for renal transplantation has continuously increased over the last decade. Type 2 diabetic patients who received a renal allograft had a higher survival rate compared with patients maintained on chronic haemodialysis treatment. Diabetic patients with a history of myocardial infarction, stroke, or peripheral gangrene before renal transplantation had a worse prognosis compared with patients without vascular complications. No significant difference of survival was observed between type 1 and type 2 diabetic patients after renal transplantation. The main causes of death were myocardial infarction and septical peripheral gangrene. A history of myocardial infarction, stroke, peripheral gangrene is an independent predictor of decreased survival in type 2 diabetic patients. Renal transplantation improved survival of diabetic patients without vascular complications and should be considered as the treatment of choice in this group of patients. However, a prospective multicentre study should be initiated to establish guidelines for the management of type 2 diabetic patients with end-stage renal disease.