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Linz, Austria

Bodlaj G.,Section Nephrology | Biesenbach G.,Section Nephrology
Diabetology and Metabolic Syndrome

In rare cases (1-8%) diabetic patients with end-stage renal disease (ESRD) suffer from diabetic nephropathy (dNP) due to pancreatic diabetes mellitus (PDM). Aim of this study was to investigate differences in the outcome of patients with PDM and those with type 2 diabetes. In a retrospective study we evaluated 96 diabetic patients, who started hemodialysis (HD) in our dialysis centre (1997-2005). In 12 patients PMD was diagnosed, and 84 patients had type 2 diabetes. In both groups we compared vascular risk factors and prevalence of vascular diseases at the start of dialysis. We also evaluated incidence of malnutrition, and 5-year survival in both patient groups. The vascular risk factors were similar in both patient groups, also the prevalence of vascular diseases at the initiation of HD was similar in both groups. In the patients with PDM the mean BMI (kg/m 2) was lower (22 + 3 versus 25 + 3), and also their serum albumin was lower (2.7 + 0.3 versus 3.4 + 0.3 g/dl, p < 0.05). Four of these patients (33%) developed malnutrition (BMI < 18.5). In the patients with PDM the age adjusted 5-year survival was significantly lower (8% versus 27%, p < 0.05) than in the type 2 diabetic patients. Conclusions in HD-treated patients with type 2 diabetes or PDM the prevalence of vascular diseases was not significantly different. The lower survival of PDM patients can be related to poor nutrition status. Copyright © 2012 Bodlaj and Biesenbach; licensee BioMed Central Ltd. Source

Biesenbach G.,Section Nephrology | Pohanka E.,Section Nephrology
Nature Reviews Nephrology

Levels of glycated albumin seem to predict mortality and hospitalization more accurately than does levels of glycated hemoglobin in patients with diabetes mellitus who are on dialysis. Should we be measuring glycated albumin instead of glycated hemoglobin in this group of patients? © 2011 Macmillan Publishers Limited. All rights reserved. Source

Introduction: During the last decades immunosuppressive therapy of kidney transplanted patients has changed completely. Complications after kidney transplantation (KTR) mainly occur during the first 3 months. In this study we investigated the outcome of patients with KTR before 1987 using cyclosporine and patients with KTR after 1986 using tacrolimus. Patients and methods: A total of 406 patients were included in the study, patients were divided into 2 groups: in group I with KTR 1986-1996 (n=182), immunosuppressive therapy was azathioprine and cyclosporine and group II with KTR 1997-2007, using mofetil mycophenolat (MMF) and tacrolimus for immunosuppression. In each group we evaluated the incidence of complications as well as incidence of kidney graft loss and death of patients 3 and 12 months after KTR Results: During the three months after KTR the incidence of acute graft rejection was significantly lower in the last decade (20% versus 38%), in contrast to that, the incidence of infections was higher during the same period (30% versus 20%). The prevalence of non-functioning grafts 3 months after KTR was slightly higher in the years 1986-1996 (20% versus 12%). Death of patients was a cause of graft loss in 12 patients in each group (33% versus 44%). Severe rejection was the cause of non functioning graft in 20 patients during 1984-1996 but only in 10 patients during the last decade (41% versus 11%, p<0.01). Conclusion: In group I rejections were more often the cause of kidney graft loss within the first 3 months after KTR compared to group II. However, the prevalence of non-functioning grafts 3 months after transplantation was only slightly lower during the last decade. The 1-year mortality was nearly the same in both groups. Source

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