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A comparative study on graft and overall survival rates between diabetic and nondiabetic kidney transplant patients through survival analysis

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dc.contributor.authorGarcía Padilla, Paola Karina
dc.contributor.authorDavila, Valentina
dc.contributor.authorHurtado Muñoz, Diana Carolina
dc.contributor.authorVargas Angel, Diana Carolina
dc.contributor.authorMuñoz, Óscar
dc.contributor.authorJurado Flórez, Mayra Alejandra
dc.contributor.corporatenamePontificia Universidad Javeriana. Facultad de Medicina. Departamento de Medicina Interna. Nefrologíaspa
dc.contributor.corporatenamePontificia Universidad Javeriana. Facultad de Medicina. Departamento de Medicina Interna. Medicina Interna
dc.contributor.javerianateacherGarcía Padilla, Paola Karina
dc.contributor.javerianateacherMuñoz, Óscar
dc.coverage.cityBogotá (Colombia)spa
dc.coverage.spatialColombiaspa
dc.coverage.temporal2004-2022spa
dc.date.accessioned2024-01-04T18:07:32Z
dc.date.available2024-01-04T18:07:32Z
dc.date.created2023-09-14
dc.description.abstractenglishBackground: Patients with diabetes mellitus (DM) have worse graft and overall survival, but recent evidence suggests that the difference is no longer significant. Objective: To compare the outcomes between patients with end-stage kidney disease due to DM (ESKD-DM) and ESKD due to nondiabetic etiology (ESKD-non-DM) who underwent kidney transplantation (KT) up to 10 years of follow-up. Design: Survival analysis of a retrospective cohort. Setting and Patients: All patients who underwent KT at the Hospital Universitario San Ignacio, Colombia, between 2004 and 2022. Measurements: Overall and graft survival in ESKD-DM and ESKD-non-DM who received KT. Patients who died with functional graft were censored for the calculation of kidney graft survival. Methods: Log-rank test, Cox proportional hazards model, and competing risk analysis were used to compare overall and graft survival in patients with ESKD-DM and ESKD-non-DM who underwent KT. Results: A total of 375 patients were included: 60 (16%) with ESKD-DM and 315 (84%) with ESKD-non-DM. Median follow-up was 83.3 months. Overall survival was lower in patients with ESKD-DM at 5 (75.0% vs 90.8%, P < .001) and 10 years (55.0% vs 86.7%, P < .001). Cardiovascular death was higher in patients with diabetes (27.3% vs 8.2%, P = .021). Death-censored graft survival was similar in both groups (96.7% vs 93.3% at 5 years, P = .324). On multivariate analysis, the factors associated with global survival were DM (hazard ratio [HR] = 2.11, 95% confidence interval [CI] = 1.23-3.60, P = .006), recipient age (HR = 1.05, 95% CI = 1.02-1.08, P < .001), delayed graft function (HR = 2.07, 95% CI = 1.24-3.46, P = .005), and donor age (HR = 1.03, 95% CI = 1.01-1.05, P = .002). In the competing risk analysis, DM was associated with mortality only in the cardiovascular death group (sub-hazard ratio [SHR] = 6.06, 95% CI = 1.01-36.4, P = .049). Limitations: Change in diabetes treatment received over time and adherence to glycemic targets were not considered. The sample size is relatively small, which limits the precision of our estimates. The Kidney Donor Profile Index and the occurrence of treated acute rejection were not included in the regression models. Conclusion: Overall survival is lower in patients with diabetes, possibly due to older age and cardiovascular comorbidities. Therefore, patients with diabetes should be followed more closely to control cardiovascular risk factors. However, there is no difference in graft survival.spa
dc.description.comunidadPacientes con trasplante de riñónspa
dc.description.esciSispa
dc.description.indexingRevista Internacional - Indexadaspa
dc.description.orcidhttps://orcid.org/0000-0001-9852-749Xspa
dc.description.orcidhttps://orcid.org/0000-0001-6563-2939spa
dc.description.orcidhttps://orcid.org/0000-0002-5301-8381spa
dc.description.orcidhttps://orcid.org/0000-0003-0077-6119spa
dc.description.orcidhttps://orcid.org/0000-0001-5401-0018spa
dc.description.orcidhttps://orcid.org/0000-0001-6967-3375spa
dc.description.publindexA2spa
dc.description.quartilescopusQ2spa
dc.description.quartilewosQ3spa
dc.formatPDFspa
dc.format.mimetypeapplication/pdfspa
dc.identifierhttps://journals.sagepub.com/doi/10.1177/20543581231199011spa
dc.identifier.doihttps://doi.org/10.1177/20543581231199011spa
dc.identifier.instnameinstname:Pontificia Universidad Javerianaspa
dc.identifier.issn2054-3581spa
dc.identifier.reponamereponame:Repositorio Institucional - Pontificia Universidad Javerianaspa
dc.identifier.repourlrepourl:https://repository.javeriana.edu.cospa
dc.identifier.urihttp://hdl.handle.net/10554/65889
dc.language.isoengspa
dc.relation.citationendpage10spa
dc.relation.citationstartpage1spa
dc.relation.citationvolume10spa
dc.relation.ispartofjournalCanadian Journal of Kidney Health and Diseasespa
dc.rights.coarhttp://purl.org/coar/access_right/c_abf2spa
dc.rights.licenceAtribución-NoComercial 4.0 Internacional*
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/*
dc.subject.keywordKidney transplantationspa
dc.subject.keywordGraft survivalspa
dc.subject.keywordPatient survivalspa
dc.subject.keywordDiabetes mellitusspa
dc.subject.keywordCause of deathspa
dc.titleA comparative study on graft and overall survival rates between diabetic and nondiabetic kidney transplant patients through survival analysisspa
dc.type.coarhttp://purl.org/coar/resource_type/c_2df8fbb1spa
dc.type.hasversionhttp://purl.org/coar/version/c_ab4af688f83e57aa
dc.type.localArtículo de revistaspa

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