Diabetes Increases Risk of Infection in Renal Transplant Recipients

Renal transplant graft recipients with diabetes, whether long-standing or newly diagnosed, are at heightened risk of developing infections requiring hospitalization in the posttransplant period. Studies have demonstrated worse renal graft survival in diabetic patients relative to nondiabetic patients, note Dr. M. Cecilia Lansang and colleagues from the University of Florida in Gainesville. "Yet, there is a paucity of data on the risk of infection, an issue that becomes even more important since posttransplant patients are already immunocompromised," they note.

Against this backdrop, Dr. Lansang’s group used data in the US Renal Data System to analyse the risk of infection in the posttransplant period in 29,966 kidney transplant recipients.

About 43% were nondiabetic, 42% had diabetes detected before or at the time of transplantation (PreTDM), and 15% had diabetes detected after transplantation (PostTDM).

The investigators found a 43% increased hazard risk for developing an infection requiring hospitalization in PreTDM compared with nondiabetic and PostTDM patients, and a 77% increased risk in PostTDM patients compared with nondiabetic patients.
"Most infections were bacterial in nature (p < 0.001)," according to the researchers. "Of these bacterial infections, septicemia tended to be the most common presentation, followed by pneumonia, urinary tract infection, and others."

"Though our study does not prove causation, it nevertheless provides more impetus toward improving the management of patients with PreTDM and PostTDM alike," Dr. Lansang and colleagues conclude.

Diabetes Care 2006;29:1659-1660.

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