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Kidney transplantation in diabetic recipients: factors leading to improved results

  • D. E. R. Sutherland
  • D. S. Fryd
  • C. E. Morrow
  • F. C. Goetz
  • R. M. Ferguson
  • R. L. Simmons
  • J. S. Najarian
Part of the Developments in Surgery book series (DISU, volume 5)

Abstract

Diabetic nephro-sclerosis in the United States has been the primary cause of death in 50% of patients with Type 1 diabetes. Diabetic nephropathy is now responsible for 25% of all new cases referred to transplant units in the United States (1). Average patient survival of diabetic patients maintained on dialysis is 60–70% at 2 years and this represents on improvement on the results obtained in the early 1970’s where only 25% of the patients were alive at 2 years (2). The results of maintaining diabetics on dialysis have improved tremendously (3) and this has also been paralleled by an improved survival after renal transplantation. It has been considered that the diabetic patient is a high risk patient for dialysis or transplantation but this is only in relation to the non-diabetic patient who receives the same treatment. It is important to consider what is the best treatment for the individual patient. Particularly since diabetic patients do better with renal transplantation then if they are maintained on dialysis. However, elderly patients tended to do better on dialysis rather than transplantation (in the pre-Cyclosporin era) and this group are therefore ‘high risk’ for transplantation.

Keywords

Diabetic Nephropathy Graft Survival Graft Survival Rate Multiple Daily Injection Diabetic Recipient 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Kjellstrand CM, Avram MM, Blagg CR, Friedman EA, Salviettera O, Simmons RL, Williams GM, Terasaki P: Panel Conference. Cadaver Transplantation versus Haemodialysis. Trans Am Soc Artif Intern Organs 26: 611–624, 1980.PubMedGoogle Scholar
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    Kjellstrand CM, Simmons RL, Goetz FC, Buselmeir TJ, Shideman JR, Von Hartitzsch B, Najarian JS: Renal Transplantation in Patients with Insulin dependent diabetes. Lancet 2: 4–8, 1973.PubMedCrossRefGoogle Scholar
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    Kjellstrand CM, Compty CM, Shapiro FL. In: Diabetic Renal Retinal Syndrome. Prevention and Management (ed. 2) (Friedman EA, L’Esperance SA Jr eds) and Stratton, New York, 1982.Google Scholar
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    Standards Committee of the American Society of Transplant Surgeons: JAMA 246: 133, 1981.CrossRefGoogle Scholar
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    Barbosa J, Menth L, Eaton J, Sutherland D, Freier EF, Najarian JS: Long term, ambulatory, subcutaneous insulin infusion versus multiple daily injections in brittle diabetic patients. Diabetes Care 4: 269–274, 1981.PubMedCrossRefGoogle Scholar

Copyright information

© Martinus Nijhoff Publishers, The Hague 1984

Authors and Affiliations

  • D. E. R. Sutherland
  • D. S. Fryd
  • C. E. Morrow
  • F. C. Goetz
  • R. M. Ferguson
  • R. L. Simmons
  • J. S. Najarian

There are no affiliations available

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