Renal transplant among type 1 and type 2 diabetes patients in Spain: A population-based study from 2002 to 2013

Background: To describe trends in the rates and short-term outcomes of renal transplants (RTx) among patients with or without diabetes in Spain (2002-2013). Methods: We used national hospital discharge data to select all hospital admissions for RTx. We divided the study period into four three-year periods. Rates were calculated stratified by diabetes status: type 1 diabetes (T1DM), type 2 diabetes (T2DM) and no-diabetes. We analyzed Charlson comorbidity index (CCI), post-transplant infections, in-hospital complications of RTx, rejection, in-hospital mortality and length of hospital stay. Findings: We identified 25,542 RTx. Rates of RTx increased significantly in T2DM patients over time (from 9.3 cases/100,000 in 2002/2004 to 13.3 cases/100,000 in 2011/2013), with higher rates among people with T2DM for all time periods. T2DM patients were older and had higher CCI values than T1DM and non-diabetic patients (CCI >= 1, 31.4%, 20.4% and 21.5%, respectively; P < 0.05). Time trend analyses showed significant increases in infections, RTx-associated complications and rejection for all groups (all P values < 0.05). Infection rates were greater in people with T2DM (20.8%) and T1DM (23.5%) than in non-diabetic people (18.7%; P < 0.05). Time trend analyses (2002-2013) showed significant decreases in mortality during admission for RTx (OR 0.75, 95% CI 0.68-0.83). Diabetes was not associated with a higher in-hospital mortality (OR: 1.20, 95% CI 0.92-1.55). Interpretation: RTx rates were higher and increased over time at a higher rate among T2DM patients. Mortality decreased over time in all groups. Diabetes does not predict mortality during admission for RTx. (C) 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.