Glucose control is associated with patient survival in diabetic patients after renal transplantation.

Transplantation
Franz WiesbauerRainer Oberbauer

Abstract

The efficacy of tight glycemic control for the prevention of death and renal failure in the general diabetic population is well established. However, in diabetic renal-allograft recipients, the effect of different treatment strategies on outcomes is undetermined. We conducted a cohort study of 798 diabetic, renal-allograft recipients transplanted at the Medical University of Vienna between 1990 and 2004. We studied the influence of glucose parameters and diabetes treatment on mortality and graft loss. Marginal-structural models and multivariable Cox regression analysis were used to control for confounding. Maximal glucose levels but not HbA1c were independently associated with mortality. Being in the highest quartile of maximal glucose increased the adjusted risk of death by a factor of 2.2 (P value for trend 0.009). Furthermore, in patients receiving insulin, the risk of death was increased 1.7-fold (95% confidence interval 0.9-3.1) compared with diet and 2.0-fold (95% confidence interval 1.1-3.7) compared with oral medication. Maximal glucose, HbA1c, or diabetes treatment did not influence death-censored functional graft survival. In conclusion, maximal glucose levels and insulin treatment were independently associated with h...Continue Reading

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Citations

Aug 9, 2012·Current Diabetes Reports·Giselle GuerraGaetano Ciancio
Apr 15, 2010·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Guntram SchernthanerGerit-Holger Schernthaner
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Nov 29, 2013·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Mehmet Sukru Sever
Mar 8, 2016·Transplantation Reviews·Domingo HernándezVíctor Abraira
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