Type 1 diabetic patients have better endothelial function after simultaneous pancreas-kidney transplantation than after kidney transplantation with continued insulin therapy.
The purpose of this study was to analyse the influence of simultaneous pancreas-kidney or kidney transplantation on endothelial function and systemic inflammation in type 1 diabetic patients with end-stage renal disease. In 39 simultaneous pancreas-kidney, 39 type 1 diabetic kidney and 52 non-diabetic kidney recipients, flow-mediated dilatation was measured. Additionally, blood glycated haemoglobin, serum creatinine and lipids, plasma nitrites [Formula: see text] and nitrates, asymmetric dimethylarginine, soluble vascular cell adhesion molecule-1, intercellular adhesion molecule-1, and E-selectin, high-sensitivity C-reactive protein, tumour necrosis factor-α, interleukin 1β and interleukin 6 concentrations were assessed. During 58 ± 31 months follow-up period, flow-mediated dilatation and [Formula: see text] were greater in simultaneous pancreas-kidney than in type 1 diabetic kidney recipients [10.4% ± 4.7% vs 7.7% ± 4.2%, p < 0.05 and 0.94 (0.74-1.34) vs 0.24 (0.20-0.43) μmol/L, p < 0.01, respectively]. In type 1 diabetic patients after simultaneous pancreas-kidney or kidney transplantation, [Formula: see text] correlated with flow-mediated dilatation (r = 0.306, p < 0.05) and with blood glycated haemoglobin (r = -0.570, p < 0.001). The difference in [Formula: see text] was linked to blood glycated haemoglobin and estimated glomerular filtration rate, whereas the difference in flow-mediated dilatation was linked to [Formula: see text]. The levels of inflammatory markers (except soluble vascular cell adhesion molecule-1) were similar in simultaneous pancreas-kidney and type 1 diabetic kidney recipients. Improved endothelial function in type 1 diabetic patients with end-stage renal disease after simultaneous pancreas-kidney compared to kidney transplantation is associated with normalisation of glucose metabolism but not with improvement in plasma pro-inflammatory cytokines.
['Ziaja|Jacek|J|', 'Kowalik|Adrian P|AP|', 'Kolonko|Aureliusz|A|', 'Kamińska|Dorota|D|', 'Owczarek|Aleksander J|AJ|', 'Kujawa-Szewieczek|Agata|A|', 'Kusztal|Mariusz A|MA|', 'Badura|Joanna|J|', 'Bożek-Pająk|Dominika|D|', 'Choręza|Piotr|P|', 'Zakrzewska|Agnieszka|A|', 'Król|Robert|R|', 'Chłopicki|Stefan|S|', 'Klinger|Marian|M|', 'Więcek|Andrzej|A|', 'Chudek|Jerzy|J|', 'Cierpka|Lech|L|']
D000328:Adult D001786:Blood Glucose D002097:C-Reactive Protein D003922:Diabetes Mellitus, Type 1 D003928:Diabetic Nephropathies D004727:Endothelium D005260:Female D005919:Glomerular Filtration Rate D006801:Humans D007328:Insulin D007668:Kidney D016030:Kidney Transplantation D008297:Male D008875:Middle Aged
Type 1 diabetes endothelial function kidney transplantation end-stage renal disease simultaneous pancreas–kidney transplantation