BACKGROUND: Renal transplantation has been established as the treatment of choice for end-stage renal disease (ESRD) due to diabetic nephropathy. This study aimed to investigate the risk factors for recurrence of diabetic nephropathy (RDN) in renal allograft.

METHODS: We studied 1011 renal transplant patients between 1986 and 2003, of which 95 had ESRD due to diabetic nephropathy. We retrospectively analyzed the clinical characteristics and outcomes of recurrence of diabetic nephropathy (RDN) after renal transplantation.

RESULTS: Of the 95 recipients with ESRD due to diabetic nephropathy, 41 patients developed recurrence of diabetic kidney disease and 11 of them underwent graft biopsy. The mean duration from transplant to RDN and renal replacement therapy was 81.58 months (range, 54-120 mo), and 109.66 months (range, 27-188.4 mo) respectively. At five years treatment on statins and RAAS blockers warranted a higher survival free from RND (82.2% vs 63.2% p 0.070 and 100% vs 80% vs 0.6%, p 0.013). Compared with Cyclosporine, Tacrolimus was associates with a higher risk for RND Treatment with tacrolimus was more diabetogenic (OR 4.27 CI95% 1.75-5.13 p0.047). High doses of prednisone (> 0.06mg/kg) were also associated with a higher risk of RDN (OR 3.03 CI 1.19-8.30, p0.029). The ICN and imTor combination demonstrated the highest risk of RDN (OR 14.08 CI 95% 3.72-53.29 p <0.01). .

CONCLUSIONS: Treatment with tacrolimus and imTor is the most diabetogenic immunosuppressive regime. Treatment with Tacrolimus entails a greater risk of RDN than Cyclosporine. The administration of statins or RAAS blockers could delay the progression of RDN.

CITATION INFORMATION: Rodriguez Cubillo B, Calvo M, Lopez De La Manzanara V, Bautista-Cañas J, Perez-Flores I, Moreno De La Higuera M, Calvo Romero N, Sanchez-Fructuoso A. Risk Factors of Recurrence of Diabetic Nephropathy in Renal Trasplant. Am J Transplant. 2017;17 (suppl 3).

« Back to 2017 American Transplant Congress