Diabetes as the Cause of End-Stage Renal Disease Affects the Pattern of Post Kidney Transplant Rehospitalizations

Abstract

Introduction Although there are reports that link diabetes-induced end-stage renal disease (ESRD) with several post renal transplantation complications and conditions, few studies have directly focused on this issue. This study compared the pattern of rehospitalizations after renal transplantation among diabetic versus nondiabetic ESRD patients, measuring causes, length of stay, outcomes and costs. Methods We retrospectively reviewed 366 randomly selected rehospitalization records of kidney transplant recipients between 1994 and 2006, including 69 who underwent renal transplantation due to diabetic nephropathy and 297, due to nondiabetic ESRD. We compared the two groups with respect to demographic and clinical variables: donor source, readmission pattern, rehospitalization cause, time interval between transplantation and hospitalization (T-H time), length of hospital stay (LOS), and intensive care unit (ICU) admission, hospital charges, and inpatient outcomes of graft loss and mortality. Results The diabetes group, compared with nondiabetic group, had a greater mean age (53 ± SD vs. 39 ± SD years), proportion of admissions due to infections (44.9% vs. 32%) or renal dysfunction (14.5% vs. 29.6%), mean hospital charges ($5056 vs. $3046), and hospital mortality (18% vs. 4.3%; P < .05). Diabetic patients were readmitted sooner after transplantation than nondiabetic patients (11 vs. 18 months; P < .05). There was no difference between the groups with regard to gender, donor source, LOS, ICU admission, and graft loss. Conclusion The etiology of ESRD should be considered for scheduling post renal transplantation follow-up. Renal transplant recipients with diabetes-induced ESRD need further attention in follow-up programs.