Diabetes Hikes Infection-Related Death Risk Post-Transplant

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ATLANTA—Diabetes mellitus is an independent risk factor for infection-related death after kidney transplantation, data presented at the American Society of Nephrology's Kidney Week 2013 meeting show.

Manvir Kaur Hayer, MBChB, and collaborators at the Renal Institute of Birmingham, Queen Elizabeth Hospital, Birmingham, U.K., analyzed data from 19,103 kidney transplant recipients, of whom 2,968 had diabetes mellitus at the time of transplantation. Following transplantation, 2,085 patients died; 433 of the deaths were due to infection. The risk for death from any cause after transplantation was significantly higher for diabetics than non-diabetics (16% vs. 10%), as was the risk for infection-related death (3.3% vs. 2.1%).

No cytomegalovirus-related death occurred among the diabetics compared with 5.7% of non-diabetics.

The study, which the investigators said is the first to specifically look at the risk for infection-related deaths among diabetics in the context of kidney transplantation, found that diabetes, increasing age, receipt of a deceased-donor kidney, socioeconomic deprivation, and peripheral vascular disease were independently associated with death from infection.

“If confirmed, our data suggests targeted immunosuppressive regimens may be required for kidney allograft recipients with known diabetes, although such clinical decisions would need to be balanced against risk of rejection,” the authors concluded in a poster presentation.


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