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Ophthalmology. 1994 Jun;101(6):1071-6.

The influence of combined kidney-pancreas transplantation on the progression of diabetic retinopathy. A case series.

Author information

1
Department of Ophthalmology and Visual Sciences, University of Wisconsin Medical School, Madison.

Abstract

PURPOSE:

To evaluate the impact of combined kidney and pancreas transplantation on the progression of advanced diabetic retinopathy.

METHODS:

The changes in diabetic retinopathy severity in patients with insulin-dependent diabetes mellitus who had kidney-pancreas transplantation (n = 51) and in those who had kidney transplantation only (n = 21) were compared. Patients were invited to baseline and 1 year follow-up examinations. Fundus photographs were graded in a masked fashion using standardized protocols.

RESULTS:

The mean age and duration of diabetes were similar for both groups. After combined transplantation, none of the patients used insulin, and their mean glycosylated hemoglobin was significantly lower (6.4% versus 10.6%) than those who underwent only kidney transplantation. There was a nonsignificant difference in overall progression of retinopathy for combined transplantation compared with kidney transplantation only (risk ratio = 0.73; 95% confidence interval, 0.31, 1.71).

CONCLUSION:

The authors found no evidence that the normalization of glycemia associated with a combined kidney-pancreas transplantation in patients with advanced proliferative diabetic retinopathy (mostly treated with photocoagulation) accelerated retinopathy progression. These data suggest that the normalization of glycemia associated with a combined kidney-pancreas transplantation does not have beneficial influence on the progression of advanced diabetic retinopathy.

PMID:
8008349
[Indexed for MEDLINE]

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