Despite advances in diabetes management, diabetic kidney transplant patients do far worse than non-diabetics. For a study, researchers intended to show the influence of type I and type II diabetes on American young adults (18-40 years old) who require kidney transplantation.
They conducted a population cohort analysis using the United Network for Organ Sharing database, which included all first-time, kidney-only transplant patients aged 18-40 from 2002 to 2019. Patients were classified based on their reason for requiring a transplant. The primary outcomes were death-censored graft failure and cumulative all-cause mortality. The Kaplan-Meier technique was used to determine death-censored graft failure and patient survival at 1, 5, and 10 years. To look for possible confounders, multivariate Cox regression was performed.
About 3,418 (8.1%) of the 42,466 transplant patients had end-stage renal disease associated with diabetes. At each time point, diabetics had greater cumulative mortality than individuals with non-diabetic causes of renal failure. In contrast, cumulative graft failure was comparable among groups. In diabetics, the adjusted hazard ratios for all-cause mortality and graft failure were 2.99 (95% CI 2.67-3.35; P<.01) and 0.98 (95% CI 0.92-1.05, P<.01), respectively.
Diabetes mellitus is a roughly threefold increase in mortality in young adult kidney transplant patients, indicating a more susceptible patient population. Future research should focus on identifying the underlying reasons for poor results in this population.