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Hospital readmissions in diabetic kidney transplant recipients with peripheral vascular disease
Author(s) -
Lubetzky Michelle,
Kamal Layla,
Ajaimy Maria,
Akalin Enver,
Kayler Liise
Publication year - 2018
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.13271
Subject(s) - medicine , dialysis , diabetes mellitus , kidney disease , kidney transplant , transplantation , retrospective cohort study , kidney transplantation , vascular disease , peripheral , hemodialysis , renal transplant , surgery , endocrinology
Abstract Background The benefits of kidney transplantation in diabetic patients with peripheral vascular disease ( PVD ) are unclear. While patients may have improved survival compared to dialysis, the burden of care after transplant has not been assessed. Methods We performed a retrospective review of adult diabetic kidney‐only transplant recipients with and without PVD transplanted from January 2012 until June 30, 2015. Results Of 203 diabetic kidney transplant recipients, 56 (27.6%) had PVD and 147 (72.4%) had no PVD . At a median of 3.14 years follow‐up, there were no significant differences in 30‐, 90‐, or 1‐year readmission rates. At 1 year after transplant, PVD patients were significantly more likely to have a greater sum of unplanned inpatient days (44.6% vs 27.9% with ≥10 inpatient days, P = .03) and at least 1 reoperation (28.6% vs. 8.7%, P < .01). At 1 year post‐transplant, there were similar rates of graft‐related reoperations; however, patients with PVD had significantly increased rates of non‐graft‐related operations of which 31.2% were PVD ‐related. Conclusions Diabetic patients with PVD utilize more resources after kidney transplant, spending more time in the hospital and undergoing more post‐transplant operations. The causes of readmission are predominantly related to progression of PVD rather than allograft complications.