Patients who develop diabetes after a kidney transplant can lower their mortality risk to a level similar to that of patients without diabetes if their blood sugar returns to normal, a new study has found.
Samsung Medical Center announced Friday that a research team led by nephrology professors Huh Wooseong, Jang Hye-ryon, and Jeon Jun-seok reached these findings after tracking 8,486 kidney transplant patients who underwent national health screenings between 2009 and 2017 through 2021.
After a kidney transplant, even patients with no prior history of diabetes are newly diagnosed with the condition at a rate of two to three out of every 10. This is because the use of immunosuppressants to prevent immune rejection after transplant, along with the body's physical stress response immediately after surgery, affects blood sugar metabolism.
According to the research team, patients who newly developed diabetes between three months and one year after a kidney transplant had a 30.9% higher mortality risk than patients without diabetes. When diabetes that developed after transplant persisted for more than a year, the mortality risk soared to 75.5%.
However, patients whose blood sugar returned to normal did not see an increase in mortality risk, even if they had developed diabetes after transplant. In this study, 33.5% of patients who developed diabetes in the early period after transplant had their blood sugar return to the normal range. The research team explained that even if blood sugar rose in the early period right after surgery, it can normalize as the body stabilizes and immunosuppressant doses are adjusted.
The positive effect of blood sugar recovery was also confirmed in patients who had diabetes before the kidney transplant. Among patients who had diabetes before transplant, 38.6% recovered to a non-diabetic state, and their mortality risk was 38.2% lower than that of patients whose diabetes persisted. In cases where patients had diabetes before transplant but recovered to a non-diabetic state, the risk of transplant failure—the complete loss of function of the transplanted kidney—showed no statistically significant difference from patients who never had diabetes. This suggests the importance of active diabetes management after a kidney transplant.
"These results show that diabetes after a kidney transplant can be sufficiently overcome," Professor Huh stressed. "Even if diabetes develops after a transplant, it is important not to be discouraged and to continue active blood sugar monitoring and treatment."
This study was published in a recent issue of the international journal Transplant International.
