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Trends in the effects of pre-transplant diabetes on mortality and cardiovascular events after kidney transplantation

Authors
Jeon, JY  | Kim, SJ | Ha, KH  | Park, JH | Park, B  | Oh, CK  | Han, SJ
Citation
Journal of diabetes investigation, 12(5). : 811-818, 2021
Journal Title
Journal of diabetes investigation
ISSN
2040-11162040-1124
Abstract
AIMS/INTRODUCTION: It is not clear whether survival in kidney transplant recipients with pre-transplant diabetes has improved over the past decades. We compared the rates of mortality and major adverse cardiovascular events (MACE) after renal transplantation in patients with and without pre-transplant diabetes. Furthermore, we investigated whether transplant era and recipient age affected the association between diabetes status and adverse events. MATERIALS AND METHODS: This retrospective cohort study included 691 patients who underwent renal transplantation between 1994 and 2016 at a single tertiary center. We compared the incidences of post-transplant mortality and four-point MACE in patients with and without pre-transplant diabetes using Kaplan-Meier analysis and the Cox proportional hazard model, and assessed the interactions between diabetes status and transplant era and recipient age. RESULTS: Of 691 kidney recipients, 143 (20.7%) had pre-transplant diabetes. The mean follow-up duration was 94.5 months. Kaplan-Meier analysis showed that patients with pre-transplant diabetes had higher incidences of post-transplant mortality and four-point MACE compared with those without pre-transplant diabetes (log-rank test, P < 0.001 for both). After adjusting for potential confounding factors, pre-transplant diabetes was associated with an increased risk of post-transplant mortality and four-point MACE (hazard ratio 1.90, 95% confidence interval 1.05-3.44, P = 0.034; and hazard ratio 1.75; 95% confidence interval 1.02-3.00, P = 0.043, respectively). The associations between pre-transplant diabetes status and all-cause mortality and four-point MACE were not affected by transplant era or recipient age. CONCLUSIONS: Pre-transplant diabetes remains a significant risk factor for mortality and four-point MACE in kidney transplant recipients.
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MeSH

DOI
10.1111/jdi.13397
PMID
32894649
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Endocrinology & Metabolism
Journal Papers > School of Medicine / Graduate School of Medicine > Biomedical Informatics
Journal Papers > School of Medicine / Graduate School of Medicine > Surgery
Ajou Authors
박, 범희  |  오, 창권  |  전, 자영  |  하, 경화  |  한, 승진
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