Pakistan journal of medical sciences · 2026
The influence of recipient's pre-existing diabetes mellitus on outcomes of living donor kidney transplant.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Shahabuddin Hina, Kiran Zareen, Khan Muhammad Tassaduq, Rasheed Abdur
Аннотация
OBJECTIVE: To determine the influence of recipients' pre-existing diabetes mellitus on the outcomes of living donor kidney transplantation.
METHODOLOGY: This prospective observational cohort study included 202 patients who underwent kidney transplantation between September 2022 and December 2023 at Dow University Hospital, Pakistan, and were stratified into two equal groups: pre-existing diabetes and non-diabetes. Patients with new-onset diabetes after transplantation were excluded. Demographic and clinical data were collected. Outcomes, including one-year patient survival and post-transplant complications, were assessed and compared.
RESULTS: Complications were high in the pre-existing diabetes group (57.4% vs. 28.7%, p <0.001). Infections occurred in 46.5% of patients with pre-existing diabetes versus 22.8% non-DM (p <0.001). Post-transplant cardiovascular events were observed in 6.9% of patients in the pre-existing DM group, whereas none were observed in the non-DM group (p = 0.014). One-year patient survival was 88.1% in the pre-existing DM group versus 95% in the non-DM group (p = 0.075). Graft-related complications did not differ significantly between the groups. Multivariate analysis identified pre-transplant congestive heart failure (HR = 99.431, [95% CI 7.709-128.441, p <0.001]), pre-transplant peripheral vascular disease (HR =7.787, [95% CI 1.197-50.682, p = 0.032]), post-transplant cardiovascular events (HR = 7.839, [95% CI 1.423-43.198, p = 0.018]), and post-transplant FBS (HR = 1.023, [95% CI 1.001-1.046, p = 0.040]) as independent predictors of mortality.
CONCLUSION: Diabetes did not influence one-year patient survival and graft-specific outcomes but led to frequent post-transplant complications. Pre- and post-transplant cardiovascular disease and elevated post-transplant FBS levels were associated with mortality. Therefore, structured pre-transplant cardiovascular assessment and optimization, ongoing post-transplant cardiovascular surveillance, and strict glycemic control are required.
METHODOLOGY: This prospective observational cohort study included 202 patients who underwent kidney transplantation between September 2022 and December 2023 at Dow University Hospital, Pakistan, and were stratified into two equal groups: pre-existing diabetes and non-diabetes. Patients with new-onset diabetes after transplantation were excluded. Demographic and clinical data were collected. Outcomes, including one-year patient survival and post-transplant complications, were assessed and compared.
RESULTS: Complications were high in the pre-existing diabetes group (57.4% vs. 28.7%, p <0.001). Infections occurred in 46.5% of patients with pre-existing diabetes versus 22.8% non-DM (p <0.001). Post-transplant cardiovascular events were observed in 6.9% of patients in the pre-existing DM group, whereas none were observed in the non-DM group (p = 0.014). One-year patient survival was 88.1% in the pre-existing DM group versus 95% in the non-DM group (p = 0.075). Graft-related complications did not differ significantly between the groups. Multivariate analysis identified pre-transplant congestive heart failure (HR = 99.431, [95% CI 7.709-128.441, p <0.001]), pre-transplant peripheral vascular disease (HR =7.787, [95% CI 1.197-50.682, p = 0.032]), post-transplant cardiovascular events (HR = 7.839, [95% CI 1.423-43.198, p = 0.018]), and post-transplant FBS (HR = 1.023, [95% CI 1.001-1.046, p = 0.040]) as independent predictors of mortality.
CONCLUSION: Diabetes did not influence one-year patient survival and graft-specific outcomes but led to frequent post-transplant complications. Pre- and post-transplant cardiovascular disease and elevated post-transplant FBS levels were associated with mortality. Therefore, structured pre-transplant cardiovascular assessment and optimization, ongoing post-transplant cardiovascular surveillance, and strict glycemic control are required.