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The impact of diabetes and hypertension on renal allograft survival-A single center study

摘要Background:To determine the impact of pre-transplant diabetes mellitus(DM)and post-transplant hypertension(HT)at 1 year on renal allograft survival in all adult first kidney-only(FKO)transplant recipients at a single transplant center in Johannesburg,South Africa.Materials and methods:A retrospective review was conducted of all adult FKO transplant procedures at the Charlotte Maxeke Johannesburg Academic Hospital transplant unit between 1966 and 2013.Results:During the stipulated timeframe,1685 adult FKO transplant procedures were performed.Of these,84.1%were from de-ceased donors(n=1413/1685).The prevalence of pre-transplant DM transplant recipients with no missing or incomplete records was 6.5%(n=107/1625).Of the total cohort of 1685 adult FKO transplant recipients,63.6%of those with no missing data survived to 1 year(n=1072/1685).The prevalence of HT at 1-year post-transplant was 53.6%(n=503/1072).HT at 1-year post-transplant,even after adjusted survival analysis,proved a significant risk factor for renal allograft loss(hazard ratio,1.63;95%confidence interval,1.37-1.94)(p<0.0001).Similarly,after adjusted survival analysis,the risk of renal allograft loss within the pre-transplant DM group was significantly higher(p=0.043;hazard ratio,1.26;95%confidence interval,1.01-1.58).Conclusions:This study identified pre-transplantation diabetes mellitus and post-transplantation HT as significant risk factors for graft loss within the population assessed in this region of the world.These factors could potentially be used as independent predictors of renal graft survival.

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作者 Sumesh Padayachee [1] Ahmed Adam [2] June Fabian [3] 学术成果认领
作者单位 Division of Urology,School of Clinical Medicine,Faculty of Health Sciences,University of the Witwatersrand,Johannesburg,South Africa [1] Division of Urology,School of Clinical Medicine,Faculty of Health Sciences,University of the Witwatersrand,Johannesburg,South Africa;Departments of Urology,Charlotte Maxeke Johannesburg Academic Hospital(CMJAH),Helen Joseph Hospital(HJH),and Rahima;Moosa Mother & Child Hospital(RMMCh);Wits Donald Gordon Medical Center,Johannesburg,South Africa [2] Wits Donald Gordon Medical Center,School of Clinical Medicine,Faculty of Health Sciences,University of the Witwatersrand,Johannesburg,South Africa [3]
DOI 10.1097/CU9.0000000000000068
发布时间 2024-04-30
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