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Trifonova OP, Maslov DL, Balashova EE, Lichtenberg S, Lokhov PG. Potential Plasma Metabolite Biomarkers of Diabetic Nephropathy: Untargeted Metabolomics Study. J Pers Med 2022; 12:1889. [PMID: 36422065 PMCID: PMC9692474 DOI: 10.3390/jpm12111889] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/04/2022] [Accepted: 11/09/2022] [Indexed: 09/21/2023] Open
Abstract
Diabetic nephropathy (DN) is one of the specific complications of diabetes mellitus and one of the leading kidney-related disorders, often requiring renal replacement therapy. Currently, the tests commonly used for the diagnosis of DN, albuminuria (AU) and glomerular filtration rate (GFR), have limited sensitivity and specificity and can usually be noted when typical morphological changes in the kidney have already been manifested. That is why the extreme urgency of the problem of early diagnosis of this disease exists. The untargeted metabolomics analysis of blood plasma samples from 80 patients with type 1 diabetes and early and late stages of DN according to GFR was performed using direct injection mass spectrometry and bioinformatics analysis for diagnosing signatures construction. Among the dysregulated metabolites, combinations of 15 compounds, including amino acids and derivatives, monosaccharides, organic acids, and uremic toxins were selected for signatures for DN diagnosis. The selected metabolite combinations have shown high performance for diagnosing of DN, especially for the late stage (up to 99%). Despite the metabolite signature determined for the early stage of DN being characterized by a diagnostic performance of 81%, these metabolites as potential biomarkers might be useful in the evaluation of treatment of the disease, especially at early stages that may reduce the risk of kidney failure development.
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Affiliation(s)
- Oxana P. Trifonova
- Institute of Biomedical Chemistry, 10 Building 8, Pogodinskaya Street, 119121 Moscow, Russia
| | - Dmitry L. Maslov
- Institute of Biomedical Chemistry, 10 Building 8, Pogodinskaya Street, 119121 Moscow, Russia
| | - Elena E. Balashova
- Institute of Biomedical Chemistry, 10 Building 8, Pogodinskaya Street, 119121 Moscow, Russia
| | - Steven Lichtenberg
- Institute of Biomedical Chemistry, 10 Building 8, Pogodinskaya Street, 119121 Moscow, Russia
- Metabometrics, Inc., 651 N Broad Street, Suite 205 #1370, Middletown, DE 19709, USA
| | - Petr G. Lokhov
- Institute of Biomedical Chemistry, 10 Building 8, Pogodinskaya Street, 119121 Moscow, Russia
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Delautre A, Hannedouche T, Couchoud C, Guiserix J, Cerasuolo D, Chantrel F, Martzloff J, Keller N, Krummel T. Diabetic kidney disease versus non‐diabetic kidney disease in type 2 diabetic patients on dialysis: An observational cohort. Endocrinol Diabetes Metab 2022; 5:e00281. [PMID: 35488507 PMCID: PMC9258992 DOI: 10.1002/edm2.281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 05/28/2021] [Accepted: 05/30/2021] [Indexed: 12/01/2022] Open
Abstract
Background All chronic kidney diseases in diabetic patients are not diabetic kidney diseases. The objective was to compare the clinical characteristics, survival and access to transplantation in diabetic patients starting dialysis and classified either as diabetic kidney disease (DKD) or non‐diabetic kidney disease in diabetic patients (NDKD). Methods We used the nationwide French REIN registry to analyse baseline clinical characteristics at dialysis inception and outcomes defined as kidney transplantation, deaths and their causes. The probability of death or transplantation was analysed using a multivariate Cox model and the Fine and Gray competing for risk model (sdHT). Results We included 65,136 patients from January 2009 to December 2015 with a median follow‐up of 31 months. The cumulative incidence of kidney transplantation over eight years was 46.9% (44.8–48.9) in non‐diabetic patients (ND), higher than the 19.3% (17.5–21.2) in the DKD group and 22.2% (18.4–26.7) in the NDKD group. The risk of death was significantly higher in the NDKD group than in the DKD group, even after accounting for the competing risk of transplantation (NDKD/sdHR 1.22; 95%CI 1.18–1.27; p < 0.005 vs. DKD/sdHR 1.12; 95%CI 1.08–1.16; p < 0.005 with adjustment for age, sex, major adverse cardiovascular events, cancer and chronic respiratory failure, compared to ND). Conclusions In diabetic patients starting dialysis, patients in the DKD group had reduced access to kidney transplantation. NDKD patients had a higher risk of mortality than DKD. The distinction between DKD and NDKD should be accounted for in the plan of care of diabetic patients starting dialysis.
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Affiliation(s)
- Arnaud Delautre
- Service de Néphrologie et Dialyse Hôpitaux Universitaires de Strasbourg Strasbourg France
- Faculté de Médecine Université de Strasbourg Strasbourg France
| | - Thierry Hannedouche
- Service de Néphrologie et Dialyse Hôpitaux Universitaires de Strasbourg Strasbourg France
- Faculté de Médecine Université de Strasbourg Strasbourg France
| | | | - José Guiserix
- Centre Hospitalier Universitaire de La Réunion Mayotte France
| | | | - François Chantrel
- Service de Nephrologie Centre Hospitalier Emile Muller de Mulhouse Mulhouse France
| | - Jonas Martzloff
- Service de Néphrologie et Dialyse Hôpitaux Universitaires de Strasbourg Strasbourg France
- Faculté de Médecine Université de Strasbourg Strasbourg France
| | - Nicolas Keller
- Service de Néphrologie et Dialyse Hôpitaux Universitaires de Strasbourg Strasbourg France
| | - Thierry Krummel
- Service de Néphrologie et Dialyse Hôpitaux Universitaires de Strasbourg Strasbourg France
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3
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Zhong R, Farag MA, Chen M, He C, Xiao J. Recent advances in the biosynthesis, structure–activity relationships, formulations, pharmacology, and clinical trials of fisetin. EFOOD 2022. [DOI: 10.1002/efd2.3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Affiliation(s)
- Ruting Zhong
- Institute of Chinese Medical Sciences, State Key Laboratory of Quality Research in Chinese Medicine University of Macau Macau China
| | - Mohamed A. Farag
- Pharmacognosy Department, College of Pharmacy Cairo University Cairo Egypt
| | - Meiwan Chen
- Institute of Chinese Medical Sciences, State Key Laboratory of Quality Research in Chinese Medicine University of Macau Macau China
| | - Chengwei He
- Institute of Chinese Medical Sciences, State Key Laboratory of Quality Research in Chinese Medicine University of Macau Macau China
| | - Jianbo Xiao
- Department of Analytical and Food Chemistry, Faculty of Sciences Universidade de Vigo Ourense Spain
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Lange UG, Rademacher S, Zirnstein B, Sucher R, Semmling K, Bobbert P, Lederer AA, Buchloh D, Seidemann L, Seehofer D, Jahn N, Hau HM. Cardiovascular outcomes after simultaneous pancreas kidney transplantation compared to kidney transplantation alone: a propensity score matching analysis. BMC Nephrol 2021; 22:347. [PMID: 34674648 PMCID: PMC8529792 DOI: 10.1186/s12882-021-02522-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 09/01/2021] [Indexed: 11/10/2022] Open
Abstract
Background Coronary heart disease due to arteriosclerosis is the leading cause of death in type 1 diabetic patients with end-stage renal disease (ESRD). The aim of this study was to evaluate the effect of simultaneous pancreas kidney transplantation (SPKT) compared to kidney transplantation alone (KTA) on survival, cardiovascular function and metabolic outcomes. Methods A cohort of 127 insulin-dependent diabetes mellitus (IDDM) patients with ESRD who underwent either SPKT (n = 100) or KTA (n = 27) between 1998 and 2019 at the University Hospital of Leipzig were retrospectively evaluated with regard to cardiovascular and metabolic function/outcomes as well as survival rates. An additional focus was placed on the echocardiographic assessment of systolic and diastolic cardiac function pretransplant and during follow-up. To avoid selection bias, a 2:1 propensity score matching analysis (PSM) was performed. Results After PSM, a total of 63 patients were identified; 42 patients underwent SPKT, and 21 patients received KTA. Compared with the KTA group, SPKT recipients received organs from younger donors (p < 0.05) and donor BMI was higher (p = 0.09). The risk factor-adjusted hazard ratio for mortality in SPKT recipients compared to KTA recipients was 0.63 (CI: 0.49–0.89; P < 0.05). The incidence of pretransplant cardiovascular events was higher in the KTA group (KTA: n = 10, 47% versus SPKT: n = 10, 23%; p = 0.06), but this difference was not significant. However, the occurrence of cardiovascular events in the SPKT group (n = 3, 7%) was significantly diminished after transplantation compared to that in the KTA recipients (n = 6, 28%; p = 0.02). The cardiovascular death rate was higher in KTA recipients (19%) than in SPK recipients with functioning grafts (3.3%) and comparable to that in patients with failed SPKT (16.7%) (p = 0.16). In line with pretransplant values, SPKT recipients showed significant improvements in Hb1ac values (p = 0.001), blood pressure control (p = < 0.005) and low-density lipoprotein/high-density lipoprotein (LDL/HDL) ratio (p = < 0.005) 5 years after transplantation. With regard to echocardiographic assessment, SPKT recipients showed significant improvements in left ventricular systolic parameters during follow-up. Conclusions Normoglycaemia and improvement of lipid metabolism and blood pressure control achieved by successful SPKT are associated with beneficial effects on survival, cardiovascular outcomes and systolic left ventricular cardiac function. Future studies with larger samples are needed to make predictions regarding cardiovascular events and graft survival. Supplementary Information The online version contains supplementary material available at 10.1186/s12882-021-02522-8.
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Affiliation(s)
- U G Lange
- University Hospital Leipzig, Clinic of Visceral, Transplant, Thoracic and Vascular Surgery, Liebigstrasse 20, 04103, Leipzig, Saxony, Germany
| | - S Rademacher
- University Hospital Leipzig, Clinic of Visceral, Transplant, Thoracic and Vascular Surgery, Liebigstrasse 20, 04103, Leipzig, Saxony, Germany
| | - B Zirnstein
- Sana Hospital Borna, Clinic of Anaesthesia, Intensive Care and Palliative Medicine, Rudolf-Virchow-Strasse 2, 04552, Borna, Saxony, Germany
| | - R Sucher
- University Hospital Leipzig, Clinic of Visceral, Transplant, Thoracic and Vascular Surgery, Liebigstrasse 20, 04103, Leipzig, Saxony, Germany
| | - K Semmling
- University Hospital Leipzig, Clinic of Visceral, Transplant, Thoracic and Vascular Surgery, Liebigstrasse 20, 04103, Leipzig, Saxony, Germany
| | - P Bobbert
- Ev. Hubertus Hospital Berlin, Clinic of Internal Medicine and Angiology, Spanische Allee 10-14, 14129, Berlin, Berlin, Germany
| | - A A Lederer
- University Hospital Leipzig, Clinic of Visceral, Transplant, Thoracic and Vascular Surgery, Liebigstrasse 20, 04103, Leipzig, Saxony, Germany
| | - D Buchloh
- University Hospital Leipzig, Clinic of Visceral, Transplant, Thoracic and Vascular Surgery, Liebigstrasse 20, 04103, Leipzig, Saxony, Germany
| | - L Seidemann
- University Hospital Leipzig, Clinic of Visceral, Transplant, Thoracic and Vascular Surgery, Liebigstrasse 20, 04103, Leipzig, Saxony, Germany
| | - D Seehofer
- University Hospital Leipzig, Clinic of Visceral, Transplant, Thoracic and Vascular Surgery, Liebigstrasse 20, 04103, Leipzig, Saxony, Germany
| | - N Jahn
- Department of Anesthesiology and Intensive Care Medicine, University Hospital of Leipzig, Liebigstrasse 20, 04103, Leipzig, Germany
| | - H-M Hau
- University Hospital Leipzig, Clinic of Visceral, Transplant, Thoracic and Vascular Surgery, Liebigstrasse 20, 04103, Leipzig, Saxony, Germany. .,Department of Visceral, Thoracic and Vascular Surgery, University Hospital and Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
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5
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Salamin P, Deslarzes-Dubuis C, Longchamp A, Petitprez S, Venetz JP, Corpataux JM, Déglise S. Predictive factors of surgical complications in the first year following kidney transplantation. Ann Vasc Surg 2021; 83:142-151. [PMID: 34687888 DOI: 10.1016/j.avsg.2021.08.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 07/31/2021] [Accepted: 08/05/2021] [Indexed: 11/01/2022]
Abstract
BACKGROUND In the recent years, an increased use of marginal donors and grafts and a growing prevalence of peripheral arterial disease in the recipients have been observed. Meanwhile, the open surgical technique for kidney transplantation has not changed. The aim of this study is to analyze all surgical complications occurring in the first year after kidney transplant and to determine potential predictive risk factors. METHOD Data of the 399 patients who underwent kidney transplant in our University Hospital between January 2006 and December 2015 were retrospectively reviewed. The primary endpoint was the overall rate of vascular, parietal and urological complications at 1 year following kidney transplantation. The secondary outcomes were graft and patient' survival rates, and the identification of predictive factors of the surgical complications. RESULTS Twenty-four percent of patients developed 134 complications. Vascular complication represented 39% of all complications and resulted in 9 graft losses. Parietal and urological complications represented 46% and 15% of all complications, respectively, No parietal or urological complications were associated with graft loss. Five patients died during the first year, none of these cases was associated with graft loss. The graft survival rate reached 96% at 1 year, including patients still alive. The occurrence of surgical complication was associated with reduced graft survival at 1 year. Using a multivariate analysis, 4 predictive factors were identified: age, deceased donor, operative time and dyslipidemia. CONCLUSION Surgical complications after kidney transplantation remained frequent and age, deceased kidney donors, and operative time were identified as risk factors. As vascular complications were a major cause of early graft loss, efforts should aim to reduce their occurrence to increase graft survival.
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Affiliation(s)
- Pauline Salamin
- Department of Vascular Surgery, Lausanne University Hospital (CHUV) and University of Lausanne, Suisse
| | - Céline Deslarzes-Dubuis
- Department of Vascular Surgery, Lausanne University Hospital (CHUV) and University of Lausanne, Suisse
| | - Alban Longchamp
- Department of Vascular Surgery, Lausanne University Hospital (CHUV) and University of Lausanne, Suisse
| | - Séverine Petitprez
- Department of Vascular Surgery, Lausanne University Hospital (CHUV) and University of Lausanne, Suisse
| | - Jean-Pierre Venetz
- Department of Organ Transplantation, Lausanne University Hospital (CHUV) and University of Lausanne, Suisse
| | - Jean-Marc Corpataux
- Department of Vascular Surgery, Lausanne University Hospital (CHUV) and University of Lausanne, Suisse
| | - Sébastien Déglise
- Department of Vascular Surgery, Lausanne University Hospital (CHUV) and University of Lausanne, Suisse.
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Martynov SA, Severina AS, Larina II, Shamhalova MS, Arzumanov SV, Pinchuk AV, Shestakova MV. [Preparation of the dialysis patient with type 1 diabetes mellitus for kidney transplantation]. ACTA ACUST UNITED AC 2020; 66:18-30. [PMID: 33481364 DOI: 10.14341/probl12686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 12/14/2020] [Accepted: 12/20/2020] [Indexed: 11/06/2022]
Abstract
Kidney transplantation is unique method of renal replacement therapy, allowing to improve quality and duration of life for patients with diabetes mellitus type 1 (DM1) and end-stage renal disease (ESRD) on dialysis therapy. Recently using of innovation technologies for diabetes management and modern immunosuppression enable achieving better results of posttransplant rehabilitation for patients with DM1, especially if kidney transplantation is performed early after initiation of dialysis. Detailed examination of patient with DM1 before potential kidney transplantation is very important to reduce of early and late postoperative complications. Kidney transplantation preparation includes effective glycemic control, adequate dialysis therapy, treatment of diabetes and ESRD complications and concomitant conditions, especially cardiovascular diseases, accounting for kidney transplantation perspective. Furthermore, diagnostics and treatment of any infectious process, timely vaccination, cancer screening are basic approaches of kidney transplantation preparation program, providing the best survival rate of kidney graft and patient.
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Affiliation(s)
| | | | | | | | - S V Arzumanov
- N.A. Lopatkin Research Institute of Urology and Interventional Radiology - branch of the National Medical Radiological Research Centre
| | - A V Pinchuk
- Sklifosovsky Research Institute for Emergency Medicine
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7
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Abstract
PURPOSE OF REVIEW This review focuses on the relationships between diabetes, cognitive impairment, and the contribution of kidney disease. RECENT FINDINGS We review the independent contributions of parameters of kidney disease, including albuminuria, glomerular filtration, bone/mineral metabolism, and vitamin D synthesis, on cognitive performance in patients with diabetes. Potential pathophysiologic mechanisms underlying these associations are discussed highlighting gaps in existing knowledge. Finally, effects of the dialysis procedure on the brain and cognitive performance are considered. Emphasis is placed on novel non-invasive screening tools with the potential to preserve cerebral perfusion during hemodialysis and limit cognitive decline in patients with diabetic ESKD. Patients with type 2 diabetes and advanced chronic kidney disease suffer a higher prevalence of cognitive impairment. This is particularly true in patients with diabetes and end-stage kidney disease (ESKD).
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Affiliation(s)
- Shivani Ghoshal
- Department of Neurology, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC, 27157, USA.
| | - Nicholette D Allred
- Department of Biochemistry and Center for Genomics and Personalized Medicine Research, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Barry I Freedman
- Department of Internal Medicine, Section on Nephrology, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC, 27157-1053, USA.
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8
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Flatt AJS, Bennett D, Counter C, Brown AL, White SA, Shaw JAM. β-Cell and renal transplantation options for diabetes. Diabet Med 2020; 37:580-592. [PMID: 31705689 DOI: 10.1111/dme.14177] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/07/2019] [Indexed: 12/16/2022]
Abstract
Despite major advances in structured education, insulin delivery and glucose monitoring, diabetes self-management remains an unremitting challenge. Insulin therapy is inextricably linked to risk of dangerous hypoglycaemia and sustained hyperglycaemia remains a leading cause of renal failure. This review sets out to demystify transplantation for diabetes multidisciplinary teams, facilitating consideration and incorporation within holistic overall person-centred management. Deceased and living donor kidney, whole pancreas and isolated islet transplant procedures, indications and potential benefits are described, in addition to outcomes within the integrated UK transplant programme.
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Affiliation(s)
- A J S Flatt
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
- Institute of Transplantation, Freeman Hospital, Newcastle upon Tyne, UK
| | - D Bennett
- Institute of Transplantation, Freeman Hospital, Newcastle upon Tyne, UK
| | - C Counter
- Statistics and Clinical Studies, NHS Blood and Transplant, Bristol, UK
| | - A L Brown
- Institute of Transplantation, Freeman Hospital, Newcastle upon Tyne, UK
| | - S A White
- Institute of Transplantation, Freeman Hospital, Newcastle upon Tyne, UK
| | - J A M Shaw
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
- Institute of Transplantation, Freeman Hospital, Newcastle upon Tyne, UK
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Venkatanarasimhamoorthy VS, Barlow AD. Simultaneous Pancreas-Kidney Transplantation Versus Living Donor Kidney Transplantation Alone: an Outcome-Driven Choice? Curr Diab Rep 2018; 18:67. [PMID: 30030637 PMCID: PMC6061188 DOI: 10.1007/s11892-018-1039-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE OF REVIEW The choice of optimum transplant in a patient with type 1 diabetes mellitus (T1DM) and chronic kidney disease stage V (CKD V) is not clear. The purpose of this review was to investigate this in more detail-in particular the choice between a simultaneous pancreas-kidney transplantation (SPKT) and living donor kidney transplantation (LDKT), including recent evidence, to aid clinicians and their patients in making an informed choice in their care. RECENT FINDINGS Analyses of large databases have recently shown SPKT to have better survival rates than a LDKT in the long-term, despite an early increase in morbidity and mortality in SPKT recipients. This survival advantage has only been shown in those SPKT recipients with a functioning pancreas and not those who had early pancreas graft loss. The choice of SPKT or LDKT should not be based on patient and graft survival outcomes alone. Individual patient circumstances, preferences, and comorbidities, among other factors should form an important part of the decision-making process. In general, an SPKT should be considered in those patients not on dialysis and LDKT in those nearing or already on dialysis.
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Affiliation(s)
| | - Adam D Barlow
- Consultant Transplant Surgeon, St James's University Hospital, Beckett Street, Leeds, LS9 7TF, UK.
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López-de-Andrés A, de Miguel-Yanes JM, Hernández-Barrera V, Méndez-Bailón M, González-Pascual M, de Miguel-Díez J, Salinero-Fort MA, Pérez-Farinós N, Jiménez-Trujillo I, Jiménez-García R. Renal transplant among type 1 and type 2 diabetes patients in Spain: A population-based study from 2002 to 2013. Eur J Intern Med 2017; 37:64-68. [PMID: 27514870 DOI: 10.1016/j.ejim.2016.07.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 06/11/2016] [Accepted: 07/27/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND To describe trends in the rates and short-term outcomes of renal transplants (RTx) among patients with or without diabetes in Spain (2002-2013). METHODS We used national hospital discharge data to select all hospital admissions for RTx. We divided the study period into four three-year periods. Rates were calculated stratified by diabetes status: type 1 diabetes (T1DM), type 2 diabetes (T2DM) and no-diabetes. We analyzed Charlson comorbidity index (CCI), post-transplant infections, in-hospital complications of RTx, rejection, in-hospital mortality and length of hospital stay. FINDINGS We identified 25,542 RTx. Rates of RTx increased significantly in T2DM patients over time (from 9.3 cases/100,000 in 2002/2004 to 13.3 cases/100,000 in 2011/2013), with higher rates among people with T2DM for all time periods. T2DM patients were older and had higher CCI values than T1DM and non-diabetic patients (CCI≥1, 31.4%, 20.4% and 21.5%, respectively; P<0.05). Time trend analyses showed significant increases in infections, RTx-associated complications and rejection for all groups (all P values<0.05). Infection rates were greater in people with T2DM (20.8%) and T1DM (23.5%) than in non-diabetic people (18.7%; P<0.05). Time trend analyses (2002-2013) showed significant decreases in mortality during admission for RTx (OR 0.75, 95% CI 0.68-0.83). Diabetes was not associated with a higher in-hospital mortality (OR: 1.20, 95% CI 0.92-1.55). INTERPRETATION RTx rates were higher and increased over time at a higher rate among T2DM patients. Mortality decreased over time in all groups. Diabetes does not predict mortality during admission for RTx. FUNDING Instituto Salud Carlos III and URJC-Banco Santander.
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Affiliation(s)
- Ana López-de-Andrés
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Avenida de Atenas s/n. 28292, Alcorcón, Madrid, Spain.
| | - José M de Miguel-Yanes
- Internal Medicine Department, Hospital General Universitario Gregorio Marañón, 46, Doctor Esquerdo, 28007 Madrid, Spain.
| | - Valentín Hernández-Barrera
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Avenida de Atenas s/n. 28292, Alcorcón, Madrid, Spain.
| | - Manuel Méndez-Bailón
- Internal Medicine Department, Hospital Universitario Clínico San Carlos, Profesor Martín Lagos, s/n. 28040, Madrid, Spain.
| | - Montserrat González-Pascual
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Avenida de Atenas s/n. 28292, Alcorcón, Madrid, Spain.
| | - Javier de Miguel-Díez
- Respiratory Care Department, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, 46, Doctor Esquerdo, 28007 Madrid, Spain.
| | - Miguel A Salinero-Fort
- Dirección Técnica de Docencia e Investigación, Gerencia Atención Primaria, 24, Espronceda, 28003 Madrid, Spain.
| | - Napoleón Pérez-Farinós
- Health Security Agency Ministry of Health, Social Services and Equality, 56, Alcalá, 28071 Madrid, Spain.
| | - Isabel Jiménez-Trujillo
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Avenida de Atenas s/n. 28292, Alcorcón, Madrid, Spain.
| | - Rodrigo Jiménez-García
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Avenida de Atenas s/n. 28292, Alcorcón, Madrid, Spain.
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