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Mark Molitch Part 6, Post- and Pre-Kidney Transplant Treatment

In part 6 of this Exclusive Interview, Dr. Mark Molitch explains the diabetes treatment objective in patients who have undergone a kidney transplant in a conversation with Diabetes in Control Publisher Steve Freed during the ADA meeting in San Diego, California.

Dr. Mark Molitch is the Martha Leland Sherwin Professor of Medicine at Northwestern in the
Division of Endocrinology, Metabolism and Molecular Medicine. He has been active in clinical research in diabetes, focusing on diabetic nephropathy, and other areas of endocrinology.

Transcript of this video segment:

Steve Freed: What kind of diabetes control is necessary after a kidney transplant?

Mark Molitch: Well, that’s a very uncertain answer to that question, because we don’t really know. What you want to do is to try to prevent that new kidney from developing diabetic nephropathy again and so we would like the control down in the 7% range if we possibly can, but sometimes that’s a very difficult thing to do.

Steve Freed: From your experience, someone who diagnosed with end-stage renal disease and immediately put him on dialysis and they put their name on the waiting list in fairly “healthy condition” except for that. Where is he on the list? How long does a person have to wait?

Mark Molitch: Somebody like that can be on the list for 3 or 4 years, 5 years even and people with diabetes on that list don’t do well. People on dialysis with diabetes don’t do very well at all. In fact, the 5-year mortality rate is about 80%, only 20% of people are alive at the end of 5 years if they don’t get a kidney transplant, if they stay on dialysis all that time. They’ll be on that list for three, four, five years sometimes.

Steve Freed: So, you are saying, once you go on dialysis, your average lifespan is about 5 years

Mark Molitch: That’s not the average, only 20% of people are alive then, so the average is about 2 and half years. But I mean it’s not from getting dialysis. It’s because everything else is progressing at the same time, the heart disease, the kidney disease, the eyes disease at the same time. The body’s kind of falling apart, but if they get a transplant they do much better.

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