Veena Joshi
Muljibhai Patel Urology Hospital, India
Title: Clinical outcomes after renal transplantation in pre diabetic patients: Systematic review
Biography
Biography: Veena Joshi
Abstract
Aim of the study was to conduct a systematic review to summarize the outcome of renal transplantation in adult patients with history of DM [DMRTx] in 1.DMRTx , 2. type 2 DMRTx 3.DM and type 2 DM in comparisons with Non-DMRTx, 4. Type2DMRTx vs dialysis and 5. Preemptive Kidney Transplant (prekTx) vs non prekTx. MEDLINE, EMBASE, Renal transplant registries were searched for observational / cohort/ case-control studies from 1980 to 2014. Type2DM compared to DM studies recruited fewer (<100) and older(>50 years) patients. We identified 22 studies reporting survival after RTx [in DM (1),DM vs Non-DM (10), Type DM (2), Type2DM vs Non-DM (6), Type2DMRTx vs Dialysis (1), PreKTx vs Non PreKTx (2)]. 16, 7, 12, and 3 single center studies showed 1,3, 5 and 10 year patient survival respectively. Seven studies in DM group have reported 5 yr graft and patient survival where one study showed graft survival was significantly (p<.05)better in Non-DM group compared to DM group. Patient survival did not differ. Among five type2DM studies, one and three studies showed graft and patient survival in non-DM to be significantly (p<.05) better than type2DM group. 5 yr survival after RTx was significantly (p=.001) better in RTx patients compared to patients on dialysis. At 10 year, patient survival of non-DM was significantly better than DM or type2DM and survival of preemptive was similar to non-preemptive (p<.05). There is an urgent need for multi-center studies with prediabetes, especially type2DM patients to look at long term survival after renal transplant.