Ramezani M, Ghoddousi K, Hashemi M, Khoddami-Vishte H-R, Fatemi-Zadeh S, Saadat S H, Khedmat H, Naderi M
Nephrology/Urology Research Center (NURC), Baqiyatallah Medical Sciences University, Tehran, Iran.
Transplant Proc. 2007 May;39(4):966-9. doi: 10.1016/j.transproceed.2007.03.074.
Although there are reports that link diabetes-induced end-stage renal disease (ESRD) with several post renal transplantation complications and conditions, few studies have directly focused on this issue. This study compared the pattern of rehospitalizations after renal transplantation among diabetic versus nondiabetic ESRD patients, measuring causes, length of stay, outcomes and costs.
We retrospectively reviewed 366 randomly selected rehospitalization records of kidney transplant recipients between 1994 and 2006, including 69 who underwent renal transplantation due to diabetic nephropathy and 297, due to nondiabetic ESRD. We compared the two groups with respect to demographic and clinical variables: donor source, readmission pattern, rehospitalization cause, time interval between transplantation and hospitalization (T-H time), length of hospital stay (LOS), and intensive care unit (ICU) admission, hospital charges, and inpatient outcomes of graft loss and mortality.
The diabetes group, compared with nondiabetic group, had a greater mean age (53 +/- SD vs. 39 +/- SD years), proportion of admissions due to infections (44.9% vs. 32%) or renal dysfunction (14.5% vs. 29.6%), mean hospital charges ($5056 vs. $3046), and hospital mortality (18% vs. 4.3%; P<.05). Diabetic patients were readmitted sooner after transplantation than nondiabetic patients (11 vs. 18 months; P<.05). There was no difference between the groups with regard to gender, donor source, LOS, ICU admission, and graft loss.
The etiology of ESRD should be considered for scheduling post renal transplantation follow-up. Renal transplant recipients with diabetes-induced ESRD need further attention in follow-up programs.
尽管有报告将糖尿病所致终末期肾病（ESRD）与肾移植术后的几种并发症及情况联系起来，但很少有研究直接聚焦于这一问题。本研究比较了糖尿病与非糖尿病ESRD患者肾移植术后的再次住院模式，对病因、住院时间、结局及费用进行了评估。
我们回顾性分析了1994年至2006年间随机选取的366例肾移植受者的再次住院记录，其中69例因糖尿病肾病接受肾移植，297例因非糖尿病ESRD接受肾移植。我们比较了两组在人口统计学和临床变量方面的情况：供体来源、再次入院模式、再次住院原因、移植与住院之间的时间间隔（T-H时间）、住院时间（LOS）、重症监护病房（ICU）入住情况、住院费用以及移植肾丢失和死亡的住院结局。
与非糖尿病组相比，糖尿病组的平均年龄更大（53±标准差岁对39±标准差岁），因感染（44.9%对32%）或肾功能不全（14.5%对29.6%）入院的比例更高，平均住院费用更高（5056美元对3046美元），住院死亡率更高（18%对4.3%；P<0.05）。糖尿病患者移植后再次入院的时间比非糖尿病患者更早（11个月对18个月；P<0.05）。两组在性别、供体来源、LOS、ICU入住情况和移植肾丢失方面无差异。
在安排肾移植术后随访时应考虑ESRD的病因。糖尿病所致ESRD的肾移植受者在随访计划中需要进一步关注。
