Validation of a screening protocol for identifying low-risk candidates with type 1 diabetes mellitus for kidney with or without pancreas transplantation

Clinical Transplantation
Irene MaJohn D Scandling

Abstract

Certain clinical risk factors are associated with significant coronary artery disease in kidney transplant candidates with diabetes mellitus. We sought to validate the use of a clinical algorithm in predicting post-transplantation mortality in patients with type 1 diabetes. We also examined the prevalence of significant coronary lesions in high-risk transplant candidates. All patients with type 1 diabetes evaluated between 1991 and 2001 for kidney with/without pancreas transplantation were classified as high-risk based on the presence of any of the following risk factors: age >or=45 yr, smoking history >or=5 pack years, diabetes duration >or=25 yr or any ST-T segment abnormalities on electrocardiogram. Remaining patients were considered low risk. All high-risk candidates were advised to undergo coronary angiography. The primary outcome of interest was all-cause mortality post-transplantation. Eighty-four high-risk and 42 low-risk patients were identified. Significant coronary artery stenosis was detected in 31 high-risk candidates. Mean arterial pressure was a significant predictor of coronary stenosis (odds ratio 1.68; 95% confidence interval 1.14-2.46), adjusted for age, sex and duration of diabetes. In 75 candidates who unde...Continue Reading

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Citations

Feb 10, 2007·Nature Clinical Practice. Nephrology·John D Scandling
Nov 2, 2013·Transplantation Research·Luís Henrique Wolff GowdakJosé Jayme Galvão de Lima
Jun 13, 2009·Transplantation Reviews·Julio BittarPablo U Massari
Jan 3, 2008·Transplant International : Official Journal of the European Society for Organ Transplantation·Georg BiesenbachRaimund Margreiter
Feb 11, 2015·Journal of the American College of Surgeons·Robert J StrattaJason K Bodner
Dec 14, 2011·The Cochrane Database of Systematic Reviews·Louis W WangAngela C Webster
Apr 4, 2012·The Veterinary Quarterly·Ken Steen PedersenJens Peter Nielsen
Feb 3, 2021·Clinical Transplantation·Yinlei DongZhenhua Hu

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