Open AccessTrends in the effects of pre‐transplant diabetes on mortality and cardiovascular events after kidney transplantation
Author(s) -
Jeon Ja Young,
Kim Soo Jung,
Ha Kyoung Hwa,
Park Ji Hyun,
Park Bumhee,
Oh ChangKwon,
Han Seung Jin
Publication year - 2021
Publication title -
journal of diabetes investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.089
H-Index - 50
eISSN - 2040-1124
pISSN - 2040-1116
DOI - 10.1111/jdi.13397
Subject(s) - medicine , hazard ratio , diabetes mellitus , mace , transplantation , proportional hazards model , kidney transplantation , confidence interval , retrospective cohort study , endocrinology , percutaneous coronary intervention , myocardial infarction
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.