Kidney transplantation with and without prior dialysis therapy in diabetic patients with end-stage renal failure.

Cardiovascular disease is the main cause of death in diabetic patients. Uraemia seems to increase progression of cardiovascular morbidity. Therefore early transplantation even without pretransplant dialysis could be a way of slowing progression of cardiovascular complications in patients with endstage renal failure due to diabetic nephropathy. The risk for impaired graft survival and operation-induced complications have been considered contraindications for kidney transplantation without previous dialysis. To examine whether dialysis before transplantation influences the outcome of diabetic patients after kidney transplantation data from 125 diabetic patients receiving a kidney graft during 1973-1982 was retrospectively analyzed. Twenty-four of them were transplanted without previous dialysis. One-year patient survival was somewhat higher in patients transplanted without previous dialysis than in dialyzed patients (82 and 65%) but similar 7 years after transplantation (45% and 41%). Graft survival was also similar in both groups. Although the nondialyzed patients had had more myocardial infarctions before transplantation, prevalence of mortality in cardiovascular complications after transplantation were not increased compared with dialyzed patients. Previous dialysis did not influence surgery-related complications.