Diabetes mellitus as predictor of patient and graft survival after kidney transplantation.

BACKGROUND: In this study, we used a single-center database to examine the risks of renal transplantation in patients with diabetes mellitus (DM). We aimed to compare 1-year outcomes of survival and morbidity after renal transplantation among recipients with and without DM.
METHODS: We reviewed retrospectively 1211 adult patients who underwent renal transplantation from January 2001 to December 2010. The patients were divided into 2 groups: Those with (33%) and those without (67%) pretransplant diabetes. Unpaired Student's t tests and χ(2) tests were used to compare outcomes between diabetic and nondiabetic renal transplant recipients. We analyzed survival, renal function, development of proteinuria, rejection, and infection (requiring hospitalization).
RESULTS: Patients with diabetes were older, had a greater body mass index (mean, 29.5 vs 25.3 kg/m(2); P < .05), and had lower creatinine clearance (44.2 ± 11.4 vs 56.0 ± 18.2; P = .01). Forty-one patients died in hospital (3.4%; P = nonsignificant). Furthermore, survival rates were similar between these 2 groups. However, we found a trend toward decreased survival for those with DM at 1 year (80.4% vs 88.7%; P = .20). Mean follow-up time was 3.2 years. Infection rate within 6 months was greater among those with DM (19% vs 5%; odds ratio, 6.25). Freedom from rejection at 3 years was similar (75.2% vs 76.8%; P = .57). Multivariate analysis showed increased baseline creatinine level as a significant risk factor for survival. Body mass index >30 kg/m(2) was a significant risk factor for survival among patients with DM.
CONCLUSION: We found an increased risk of serious infections in patients with DM, particularly within the first 6 months. However, our data suggest that diabetes is not associated with worse 1-year survival or higher morbidity in renal transplant patients, as long as good blood glucose control is maintained.