ECE2014 Poster Presentations Diabetes complications (59 abstracts)
Diabetes and end-stage renal disease: clinical evaluation of diabetic renal transplant candidates
Rosa Dantas 1 , Margarida Bastos 2 , Joana Saraiva 2 , Carolina Moreno 2 , Daniela Guelho 2 , Nuno Vicente 2 , Luís Miguel Cardoso 2 , Joana Simões-Pereira 3 , Joana Guimarães 1 , Rui Alves 4 & Francisco Carrilho 1
1Serviço de Endocrinologia, Diabetes e Nutrição do Centro Hospitalar do Baixo Vouga EPE, Aveiro, Portugal; 2de Endocrinologia Diabetes e Metabolismo, Centro Hospitalar e Universitário de Coimbra, HUC-CHUC, EPE, Coimbra, Portugal; 3Instituto Português de Oncologia de Francisco Gentil, EPE, Lisboa, Portugal; 4Serviço de Urologia e Transplantação Renal, Centro Hospitalar e Universitário de Coimbra, HUC-CHUC, EPE, Coimbra, Portugal.
Introduction: Diabetes mellitus (DM) is one of the main causes of end-stage renal disease (ESRD). Renal transplantation is the most effective form or renal replacement.
Methods: Retrospective, descriptive study of a sample of 108 diabetic patients admitted as candidates to renal transplant from January 1991 to December 2011, using the SPSS programme, version 20.0.
Results: 11 women and 97 men were evaluated (medium age: 58±8.2 years (minimum: 34, maximum: 71). 86.1% had type 2 diabetes (T2DM), 10.2% had type 1 diabetes (T1DM) and 3.7% had other types of diabetes. The medium age of diagnosis (n=104) was similar in both sexes (women: 41.3±14.0 vs men: 42.2±9.1 years), but inferior in T1DM (32.8±12.0). The medium duration of the disease was 16.0±8.8 years, higher in T1DM (19.8±10.7 years). 69.4 % of patients were under insulin therapy. The medium A1C was 7.3±1.6%. 69.4% (n=75) of patients had retinopathy, and 17.3% of these had uni or bilateral amaurosis. 35.2% of the sample had neuropathy, 21.3% had peripheral vascular disease (PVD) and more than half of these (52.2%) were already submitted to amputation. 21 patients had ischemic heart disease (IHD) and 13 cerebrovascular disease (CBVD). Concurrently, 85.2% also had hypertension, 31.5 % had dyslipidemia, and 77.2 % of the patients where BMI was determined (n=92) were overweight or obese (medium BMI: 27.3 kg/m2). After an average wait time of 1.31±2.4 years, 32 candidates were transplanted. These patients tended to be younger (medium age: 52.5±8.3 years vs 60.3±7.1 in the non-transplanted), mostly men (87.5%) and T2DM (78.1%). However, the percentage of transplanted women was superior to the percentage of men (36.4 vs 29.9%), and the percentage of T1DM was higher than T2DM (36.4 vs 26.9%). Transplanted patients had an inferior medium duration of diabetes (14.3±7.8 vs 16.7±9.1 years), and the percentage of microvascular complications in these patients was: retinopathy – 68.8%; amaurosis–3.1%; neuropathy – 18.8%; PVD – 12.5%; amputation – 6.25%. About 15.6% of transplanted patients had hypertension, 28.1% had dyslipidemia and 20 patients were overweight/obese.
Conclusions: The extent of micro and macrovascular complications of diabetes is determinant to the decision of renal transplantation in diabetic patients with ESRD.
Volume 35
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