Type 2 diabetic patients on renal replacement therapy: Probability to receive renal transplantation and survival after transplantation
Type 2 diabetic (T2DM) patients on renal replacement therapy (RRT) seldom receive a kidney transplant, which is partly due to age and comorbidities. Adjusting for case mix, we investigated whether T2DM patients have equal opportunity for renal transplantation compared to other patients on dialysis,...
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| creator | Kervinen, Marjo H Lehto, Seppo Helve, Jaakko Grönhagen-Riska, Carola Finne, Patrik |
| description | Type 2 diabetic (T2DM) patients on renal replacement therapy (RRT) seldom receive a kidney transplant, which is partly due to age and comorbidities. Adjusting for case mix, we investigated whether T2DM patients have equal opportunity for renal transplantation compared to other patients on dialysis, and whether survival after transplantation is comparable.
Patients who entered RRT in Finland in 2000-2010 (n = 5419) were identified from the Finnish Registry for Kidney Diseases and followed until the end of 2012. Of these, 20% had T2DM, 14% type 1 diabetes (T1DM) and 66% other than diabetes as the cause of ESRD. Uni-/multivariate survival analysis techniques were employed to assess the probability of kidney transplantation after the start of dialysis and survival after transplantation.
T2DM patients had a relative probability of renal transplantation of 0.18 (95% CI 0.15-0.22, P |
| doi_str_mv | 10.1371/journal.pone.0201478 |
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Patients who entered RRT in Finland in 2000-2010 (n = 5419) were identified from the Finnish Registry for Kidney Diseases and followed until the end of 2012. Of these, 20% had T2DM, 14% type 1 diabetes (T1DM) and 66% other than diabetes as the cause of ESRD. Uni-/multivariate survival analysis techniques were employed to assess the probability of kidney transplantation after the start of dialysis and survival after transplantation.
T2DM patients had a relative probability of renal transplantation of 0.18 (95% CI 0.15-0.22, P<0.001) compared to T1DM patients: this increased to 0.51 (95% CI 0.36-0.72, P<0.001) after adjustment for case mix (age, gender, laboratory values and comorbidities). When T2DM patients were compared to non-diabetic patients, the corresponding relative probabilities were 0.25 (95% CI 0.20-0.30, P<0.001) and 0.59 (95% CI 0.43-0.83, P = 0.002). After renal transplantation when adjusted for age and gender, relative risk of death was 1.25 (95% CI 0.64-2.44, P = 0.518) for T1DM patients and 0.72 (0.43-1.22, P = 0.227) for other patients compared to T2DM patients.
T2DM patients had a considerably lower probability of receiving a kidney transplant, which could not be fully explained by differences in the patient characteristics. Survival within 5 years after transplantation is comparably good in T2DM patients.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0201478</identifier><identifier>PMID: 30110346</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Abdomen ; Age ; Amputation ; Angioplasty ; Biology and Life Sciences ; Cardiovascular disease ; Care and treatment ; Chronic kidney failure ; Comorbidity ; Comparative analysis ; Diabetes ; Diabetes mellitus ; Diabetes mellitus (insulin dependent) ; Diabetics ; Dialysis ; Hemodialysis ; Hospitals ; Kidney diseases ; Kidney transplantation ; Kidneys ; Laboratories ; Medical imaging ; Medical research ; Medicine and Health Sciences ; Nephrology ; Patient outcomes ; Patients ; Probability ; Renal replacement therapy ; Survival ; Survival analysis ; Therapy ; Transplantation ; Transplants & implants ; Type 2 diabetes ; Veins & arteries</subject><ispartof>PloS one, 2018-08, Vol.13 (8), p.e0201478-e0201478</ispartof><rights>COPYRIGHT 2018 Public Library of Science</rights><rights>2018 Kervinen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2018 Kervinen et al 2018 Kervinen et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-4e3c8c010de2c5afd59478105e29228d7e40c4418f3e0b02b9c5cc2e69be91dd3</citedby><cites>FETCH-LOGICAL-c692t-4e3c8c010de2c5afd59478105e29228d7e40c4418f3e0b02b9c5cc2e69be91dd3</cites><orcidid>0000-0002-3025-3303</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6093678/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6093678/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,728,781,785,865,886,2103,2929,23868,27926,27927,53793,53795</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30110346$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Remuzzi, Giuseppe</contributor><creatorcontrib>Kervinen, Marjo H</creatorcontrib><creatorcontrib>Lehto, Seppo</creatorcontrib><creatorcontrib>Helve, Jaakko</creatorcontrib><creatorcontrib>Grönhagen-Riska, Carola</creatorcontrib><creatorcontrib>Finne, Patrik</creatorcontrib><title>Type 2 diabetic patients on renal replacement therapy: Probability to receive renal transplantation and survival after transplantation</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Type 2 diabetic (T2DM) patients on renal replacement therapy (RRT) seldom receive a kidney transplant, which is partly due to age and comorbidities. Adjusting for case mix, we investigated whether T2DM patients have equal opportunity for renal transplantation compared to other patients on dialysis, and whether survival after transplantation is comparable.
Patients who entered RRT in Finland in 2000-2010 (n = 5419) were identified from the Finnish Registry for Kidney Diseases and followed until the end of 2012. Of these, 20% had T2DM, 14% type 1 diabetes (T1DM) and 66% other than diabetes as the cause of ESRD. Uni-/multivariate survival analysis techniques were employed to assess the probability of kidney transplantation after the start of dialysis and survival after transplantation.
T2DM patients had a relative probability of renal transplantation of 0.18 (95% CI 0.15-0.22, P<0.001) compared to T1DM patients: this increased to 0.51 (95% CI 0.36-0.72, P<0.001) after adjustment for case mix (age, gender, laboratory values and comorbidities). When T2DM patients were compared to non-diabetic patients, the corresponding relative probabilities were 0.25 (95% CI 0.20-0.30, P<0.001) and 0.59 (95% CI 0.43-0.83, P = 0.002). After renal transplantation when adjusted for age and gender, relative risk of death was 1.25 (95% CI 0.64-2.44, P = 0.518) for T1DM patients and 0.72 (0.43-1.22, P = 0.227) for other patients compared to T2DM patients.
T2DM patients had a considerably lower probability of receiving a kidney transplant, which could not be fully explained by differences in the patient characteristics. Survival within 5 years after transplantation is comparably good in T2DM patients.</description><subject>Abdomen</subject><subject>Age</subject><subject>Amputation</subject><subject>Angioplasty</subject><subject>Biology and Life Sciences</subject><subject>Cardiovascular disease</subject><subject>Care and treatment</subject><subject>Chronic kidney failure</subject><subject>Comorbidity</subject><subject>Comparative analysis</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Diabetes mellitus (insulin dependent)</subject><subject>Diabetics</subject><subject>Dialysis</subject><subject>Hemodialysis</subject><subject>Hospitals</subject><subject>Kidney diseases</subject><subject>Kidney transplantation</subject><subject>Kidneys</subject><subject>Laboratories</subject><subject>Medical imaging</subject><subject>Medical research</subject><subject>Medicine and Health Sciences</subject><subject>Nephrology</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Probability</subject><subject>Renal replacement therapy</subject><subject>Survival</subject><subject>Survival analysis</subject><subject>Therapy</subject><subject>Transplantation</subject><subject>Transplants & implants</subject><subject>Type 2 diabetes</subject><subject>Veins & 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2 diabetic patients on renal replacement therapy: Probability to receive renal transplantation and survival after transplantation</title><author>Kervinen, Marjo H ; Lehto, Seppo ; Helve, Jaakko ; Grönhagen-Riska, Carola ; Finne, Patrik</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-4e3c8c010de2c5afd59478105e29228d7e40c4418f3e0b02b9c5cc2e69be91dd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Abdomen</topic><topic>Age</topic><topic>Amputation</topic><topic>Angioplasty</topic><topic>Biology and Life Sciences</topic><topic>Cardiovascular disease</topic><topic>Care and treatment</topic><topic>Chronic kidney failure</topic><topic>Comorbidity</topic><topic>Comparative analysis</topic><topic>Diabetes</topic><topic>Diabetes mellitus</topic><topic>Diabetes mellitus (insulin dependent)</topic><topic>Diabetics</topic><topic>Dialysis</topic><topic>Hemodialysis</topic><topic>Hospitals</topic><topic>Kidney diseases</topic><topic>Kidney transplantation</topic><topic>Kidneys</topic><topic>Laboratories</topic><topic>Medical imaging</topic><topic>Medical research</topic><topic>Medicine and Health Sciences</topic><topic>Nephrology</topic><topic>Patient outcomes</topic><topic>Patients</topic><topic>Probability</topic><topic>Renal replacement therapy</topic><topic>Survival</topic><topic>Survival analysis</topic><topic>Therapy</topic><topic>Transplantation</topic><topic>Transplants & implants</topic><topic>Type 2 diabetes</topic><topic>Veins & arteries</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kervinen, Marjo H</creatorcontrib><creatorcontrib>Lehto, Seppo</creatorcontrib><creatorcontrib>Helve, Jaakko</creatorcontrib><creatorcontrib>Grönhagen-Riska, Carola</creatorcontrib><creatorcontrib>Finne, 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One</addtitle><date>2018-08-15</date><risdate>2018</risdate><volume>13</volume><issue>8</issue><spage>e0201478</spage><epage>e0201478</epage><pages>e0201478-e0201478</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Type 2 diabetic (T2DM) patients on renal replacement therapy (RRT) seldom receive a kidney transplant, which is partly due to age and comorbidities. Adjusting for case mix, we investigated whether T2DM patients have equal opportunity for renal transplantation compared to other patients on dialysis, and whether survival after transplantation is comparable.
Patients who entered RRT in Finland in 2000-2010 (n = 5419) were identified from the Finnish Registry for Kidney Diseases and followed until the end of 2012. Of these, 20% had T2DM, 14% type 1 diabetes (T1DM) and 66% other than diabetes as the cause of ESRD. Uni-/multivariate survival analysis techniques were employed to assess the probability of kidney transplantation after the start of dialysis and survival after transplantation.
T2DM patients had a relative probability of renal transplantation of 0.18 (95% CI 0.15-0.22, P<0.001) compared to T1DM patients: this increased to 0.51 (95% CI 0.36-0.72, P<0.001) after adjustment for case mix (age, gender, laboratory values and comorbidities). When T2DM patients were compared to non-diabetic patients, the corresponding relative probabilities were 0.25 (95% CI 0.20-0.30, P<0.001) and 0.59 (95% CI 0.43-0.83, P = 0.002). After renal transplantation when adjusted for age and gender, relative risk of death was 1.25 (95% CI 0.64-2.44, P = 0.518) for T1DM patients and 0.72 (0.43-1.22, P = 0.227) for other patients compared to T2DM patients.
T2DM patients had a considerably lower probability of receiving a kidney transplant, which could not be fully explained by differences in the patient characteristics. Survival within 5 years after transplantation is comparably good in T2DM patients.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>30110346</pmid><doi>10.1371/journal.pone.0201478</doi><tpages>e0201478</tpages><orcidid>https://orcid.org/0000-0002-3025-3303</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Abdomen Age Amputation Angioplasty Biology and Life Sciences Cardiovascular disease Care and treatment Chronic kidney failure Comorbidity Comparative analysis Diabetes Diabetes mellitus Diabetes mellitus (insulin dependent) Diabetics Dialysis Hemodialysis Hospitals Kidney diseases Kidney transplantation Kidneys Laboratories Medical imaging Medical research Medicine and Health Sciences Nephrology Patient outcomes Patients Probability Renal replacement therapy Survival Survival analysis Therapy Transplantation Transplants & implants Type 2 diabetes Veins & arteries |
| title | Type 2 diabetic patients on renal replacement therapy: Probability to receive renal transplantation and survival after transplantation |
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