Objective: To study long-term graft and patient survival following renal transplantation in diabetic and non-diabetic patients.
Material and methods: Over the time period 1985-99, 498 transplantations in 399 non-diabetic patients and 68 transplantations in 62 diabetic patients were performed. The groups were similar with respect to age and sex.
Results: The patient survival rates (diabetic versus non-diabetic patients) were 88% vs 91% (p=NS) at 1 year, 68% vs 73% (p=NS) at 5 years and 31% vs 52% (p<0.05) at 10 years. The graft survival rates (diabetic versus non-diabetic patients) were 72% vs 72% at 1 year, 52% vs 52% at 5 years and 27% vs 33% (p=NS) at 10 years. In the diabetic patients, mean haemoglobin (Hb)A1c 2 years before and 2 years after the transplantation was 7.5+/-1.4 vs 8.2+/-1.6 mmol/l (p<0.05) and the mean blood pressure was 112+/-12 vs 107+/-9 mmHg (p<0.05). Of the diabetic patients, 55% were smokers. Among the diabetic patients, graft and patient survival were independent of smoking habits, blood pressure, HbA1c and total cholesterol.
Conclusions: Graft survival was similar in diabetic and non-diabetic patients. For the first 5 years following renal transplantation, the patient survival rates in the two groups were similar. Thereafter, survival among diabetic patients was poor. Mean HbA1c was relatively high, especially after the transplantation, and this may have contributed to the more rapid progression of cardiovascular disease seen in diabetic patients with nephropathy.