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Simultaneous pancreas-kidney transplantation reduces excess mortality in type 1 diabetic patients with end-stage renal disease.

Publication ,  Journal Article
Becker, BN; Brazy, PC; Becker, YT; Odorico, JS; Pintar, TJ; Collins, BH; Pirsch, JD; Leverson, GE; Heisey, DM; Sollinger, HW
Published in: Kidney Int
May 2000

BACKGROUND: Diabetic renal disease continues to be the most significant cause of end-stage renal disease (ESRD) in the United States. Renal transplantation improves diabetic ESRD patient survival; however, the diabetic state remains associated with poor patient survival. Simultaneous pancreas-kidney (SPK) transplantation can restore normoglycemia and thus may improve outcomes. METHODS: We assessed the impact of SPK on age-range-matched type 1 diabetic patients who underwent renal transplantation at a single center. The observed/expected life span and annual mortality rates (AMRs) were used as measures of survival. A Cox proportional hazards analysis was used to analyze the impact of potential variables on mortality in SPK recipients. RESULTS: SPK transplantation (N = 335) increased the observed/expected life span compared with diabetic cadaveric (DM-Cad, N = 147) and live-donor (DM-Live, N = 160) transplant recipients (P = 0.004) and significantly reduced the AMRs (SPK, 1. 5%; DM-Cad, 6.27%; DM-Live, 3.65%, P = 0.008, SPK vs. other DM). Moreover, the SPK observed/expected life span and AMR were not significantly different from that of age-range-matched nondiabetic transplant recipients (N = 492). The only variable that was significantly associated with patient survival was discharge serum creatinine (relative risk 1.16, P < or = 0.0154). CONCLUSION: These data demonstrate that SPK improves the ability for type 1 diabetic patients to live more of their expected life span. This suggests that glycemic control, even as a late intervention in a diabetic patient's lifetime, may beneficially affect survival.

Duke Scholars

Published In

Kidney Int

DOI

ISSN

0085-2538

Publication Date

May 2000

Volume

57

Issue

5

Start / End Page

2129 / 2135

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Pancreas Transplantation
  • Male
  • Kidney Transplantation
  • Kidney Failure, Chronic
  • Humans
  • Female
  • Diabetic Nephropathies
  • Diabetes Mellitus, Type 1
  • Adult
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Becker, B. N., Brazy, P. C., Becker, Y. T., Odorico, J. S., Pintar, T. J., Collins, B. H., … Sollinger, H. W. (2000). Simultaneous pancreas-kidney transplantation reduces excess mortality in type 1 diabetic patients with end-stage renal disease. Kidney Int, 57(5), 2129–2135. https://doi.org/10.1046/j.1523-1755.2000.00064.x
Becker, B. N., P. C. Brazy, Y. T. Becker, J. S. Odorico, T. J. Pintar, B. H. Collins, J. D. Pirsch, G. E. Leverson, D. M. Heisey, and H. W. Sollinger. “Simultaneous pancreas-kidney transplantation reduces excess mortality in type 1 diabetic patients with end-stage renal disease.Kidney Int 57, no. 5 (May 2000): 2129–35. https://doi.org/10.1046/j.1523-1755.2000.00064.x.
Becker BN, Brazy PC, Becker YT, Odorico JS, Pintar TJ, Collins BH, et al. Simultaneous pancreas-kidney transplantation reduces excess mortality in type 1 diabetic patients with end-stage renal disease. Kidney Int. 2000 May;57(5):2129–35.
Becker, B. N., et al. “Simultaneous pancreas-kidney transplantation reduces excess mortality in type 1 diabetic patients with end-stage renal disease.Kidney Int, vol. 57, no. 5, May 2000, pp. 2129–35. Pubmed, doi:10.1046/j.1523-1755.2000.00064.x.
Becker BN, Brazy PC, Becker YT, Odorico JS, Pintar TJ, Collins BH, Pirsch JD, Leverson GE, Heisey DM, Sollinger HW. Simultaneous pancreas-kidney transplantation reduces excess mortality in type 1 diabetic patients with end-stage renal disease. Kidney Int. 2000 May;57(5):2129–2135.
Journal cover image

Published In

Kidney Int

DOI

ISSN

0085-2538

Publication Date

May 2000

Volume

57

Issue

5

Start / End Page

2129 / 2135

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Pancreas Transplantation
  • Male
  • Kidney Transplantation
  • Kidney Failure, Chronic
  • Humans
  • Female
  • Diabetic Nephropathies
  • Diabetes Mellitus, Type 1
  • Adult