Renal Transplant Outcome in Diabetic Patients: A Single-center Study
Sumit Acharya,1 Lushan Singh,1 Pukar Chandra Shrestha,2 Swostik Pradhananga,1 Suresh Maharjan,1 Bikram Bir Bajracharya,1 Juju Raj Shresha,1Sandesh Panthi,3 Suraj Lama,1 Kalpana Kumari Shrestha11Department of Nephrology, Shahid Dharmabhakta National Transplant Center, Bhaktapur, Nepal; 2Department of Transplant Surgery, Shahid Dharmabhakta National Transplant Center, Bhaktapur, Nepal; 3Department of Endocrinology, Grande International Hospital,Tokha, Kathmandu, Nepal.
Abstract
Introduction: Diabetes mellitus is the leading cause of end-stage renal disease (ESRD) globally. In Nepal, an estimated 3,000 new ESRD cases occur annually, with 35.6% attributed to diabetic nephropathy. Although kidney transplantation improves survival
compared to dialysis globally, outcomes among diabetic patients in Nepal remain underexplored. This study assessed outcomes of type 2 diabetic patients undergoing kidney transplant at a tertiary center.
Methods: This is a retrospective study conducted from January 1, 2012 to January 11, 2023 in the Department of Transplant Surgery and the Department of Nephrology of a tertiary hospital. Among 1,000 transplant recipients, 103 met the study criteria; 16 were lost to
follow-up, yielding a final sample of 87 patients. Patient and graft survival were analyzed using the Kaplan–Meier method (GraphPad Prism 8). Data were recorded in Microsoft Excel 2016 and analyzed using IBM SPSS 18.0, with p<0.05 considered statistically significant.
Results: The mean age of patients was 50.9 ± 6.70 years, and 89.66% had CKD secondary to hypertension and diabetes mellitus. Among them 79 (90.80%) were on hemodialysis prior to transplantation. One- and five-year patient survival was 83.9%, while death
censored graft survival was 98.90% and 97.70%, respectively. Overall mortality was 16.09%, predominantly due to infection (57.14%), with no significant difference in post transplant hospital stay between diabetic and non-diabetic patients (p=0.9).
Conclusions: The overall outcome of renal transplantation in patients with diabetic kidney disease leading to ESRD is good in terms of patient and graft survival over a 5-year follow up in our tertiary center.