Increased Mortality Due to Cardiovascular Disease in Type 1 Diabetic Patients Transplanted for End‐stage Renal Failure
Increased Mortality Due to Cardiovascular Disease in Type 1 Diabetic Patients Transplanted for End‐stage Renal Failure
复制标题
因终末期肾衰竭而进行移植的 1 型糖尿病患者因心血管疾病导致的死亡率增加
作者：
S. Kumar;M. Merchant;Philip A. Dyer;S. Martin;Alastair J. Hutchison;Rwg Johnson;A. Boulton;Ram Gokal
研究了1981年至1990年间在英格兰西北部曼彻斯特皇家医院接受肾移植的所有1型糖尿病患者的移植物和患者生存率。在此期间，对52例因糖尿病肾病导致终末期肾衰竭的1型（胰岛素依赖型）糖尿病患者进行了移植。他们与年龄，性别和移植年份相匹配的对照组以及同期移植的所有904例患者进行了比较。糖尿病患者的1年和5年移植物存活率（分别为80.8%和62.1%）低于对照组（分别为88.9%和77.9%，p = 0.02），但与所有移植物中观察到的结果相似（分别为80.4%和59.0%，p = NS）。糖尿病患者的5年生存率（76.3%）低于对照组（94.2%，p = 0.003）。心肌梗死是糖尿病患者死亡的主要原因（60%）。最近的这一大型系列研究结果表明，1型糖尿病患者的移植物和患者存活率均较好，但仍低于非糖尿病肾病患者。在接受1型糖尿病患者进行肾移植之前，更严格的移植前心脏评估和治疗可能有助于提高患者的生存率。
The graft and patient survivals following renal transplantation in all Type 1 diabetic patients transplanted within the North‐West of England between 1981 and 1990 at Manchester Royal Infirmary were studied. Fifty‐two Type 1 (insulin‐dependent) diabetic patients with end‐stage renal failure due to diabetic nephropathy were transplanted during this period. They were compared to controls matched for age, sex, and year of transplantation and also to all 904 patients transplanted during the same period. Graft survival rates at 1 and 5 years in the diabetic patients were lower (80.8% and 62.1%, respectively), compared to controls (88.9% and 77.9%, respectively, p = 0.02) but were similar to those seen in all grafts (80.4% and 59.0%, respectively, p = NS). Actuarial patient survival rate at 5 years was lower in diabetic patients (76.3%) compared to the control group (94.2%, p = 0.003). Myocardial infarction was the main cause (60%) of death in diabetic patients. The results of this large recent series indicate that good graft and patient survival rates can be obtained in Type 1 diabetic patients, although they remain poorer than those of patients with non‐diabetic renal disease. More rigorous pre‐transplantation cardiac assessment and treatment before acceptance of Type 1 diabetic patients for renal transplantation may help to improve patient survival.
100 名 I 型糖尿病患者肾移植后的长期生存。
影响因子：
6.2
作者：
Najarian,JS;Kaufman,DB;Fryd,DS;McHugh,L;Mauer,SM;Ramsay,RC;Kennedy,WR;Navarro,X;Goetz,FC;Sutherland,DE
通讯作者：
Sutherland,DE