Diabetes mellitus: A risk factor for delayed graft function after deceased donor kidney transplantation

J. Parekh, A. Bostrom, S. Feng

Research output: Contribution to journalArticlepeer-review

46 Scopus citations

Abstract

Early graft function is a major determinant of long-term outcomes after renal transplantation. Recently, recipient diabetes was identified as a risk factor for poor initial graft function in living donor renal transplantation. To further explore this association, we performed a paired analysis of deceased donor renal transplants from January 1994 to December 2005. A total of 25,523 transplant pairs were analyzed via conditional logistic regression. Diabetic recipients were older (53.16 vs. 46.75 years, p < 0.01), had a lower average panel reactive antibody (12% vs. 15%, p < 0.01) and fewer prior transplants (0.07 vs. 0.12, p < 0.01). Recipient diabetes, age, male gender, African American race, elevated peak panel reactive antibody and increased cold ischemia time were independent risk factors for delayed graft function. Specifically, diabetic recipients had increased risk of DGF on univariate analysis (odds ratio [OR] 1.32, 95% confidence interval [CI] 1.23-1.42, p < 0.01). Multivariable analysis confirmed this association but the risk differed by recipient gender; with diabetes having a greater effect in women (OR 1.66, 95% CI 1.45-1.91, p < 0.01) compared to men (OR 1.28, 95% CI 1.15-1.43, p < 0.01). It is unknown whether the deleterious impact of recipient diabetes on graft function after renal transplantation results from perioperative hyperglycemia or the chronic sequelae of diabetes.

Original languageEnglish (US)
Pages (from-to)298-303
Number of pages6
JournalAmerican Journal of Transplantation
Volume10
Issue number2
DOIs
StatePublished - Feb 2010

Keywords

  • Delayed graft function (DGF)
  • Diabetes mellitus
  • Renal graft function
  • Renal transplant
  • Risk factors

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)

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