Abstract
Objective
To evaluate the influence of diabetes mellitus (DM) on the risk of recurrent infections and immune status in
kidney transplant recipients.
kidney transplant recipients.
Materials and Methods
A retrospective study included 125 patients: 60 in the control group (without DM) and 65 in the
diabetic group. Demographics, history of infections, renal function (eGFR, creatinine), and immune parameters (CD4+,
CD8+, IL-6, TNF-α, IL-10) were analyzed. Statistical analysis: t-test, χ², ANOVA, logistic regression, ROC analysis; p<0.05
considered significant.
diabetic group. Demographics, history of infections, renal function (eGFR, creatinine), and immune parameters (CD4+,
CD8+, IL-6, TNF-α, IL-10) were analyzed. Statistical analysis: t-test, χ², ANOVA, logistic regression, ROC analysis; p<0.05
considered significant.
Results
Recurrent infections occurred in 43% of diabetic patients versus 23% in controls (p=0.02). eGFR was lower in
diabetics (56 ± 9 vs 61 ± 8 mL/min/1.73 m², p=0.04), creatinine higher (130 ± 18 vs 118 ± 14 μmol/L, p=0.04). CD4+ (35 ± 4%
vs 38 ± 4%) and CD8+ (30 ± 3% vs 32 ± 3%) were decreased, while IL-6 (9.2 ± 2.1 vs 7.1 ± 1.5) and TNF-α (7.6 ± 2.0 vs 5.5 ± 1.2)
were elevated in diabetic patients (p=0.03).
diabetics (56 ± 9 vs 61 ± 8 mL/min/1.73 m², p=0.04), creatinine higher (130 ± 18 vs 118 ± 14 μmol/L, p=0.04). CD4+ (35 ± 4%
vs 38 ± 4%) and CD8+ (30 ± 3% vs 32 ± 3%) were decreased, while IL-6 (9.2 ± 2.1 vs 7.1 ± 1.5) and TNF-α (7.6 ± 2.0 vs 5.5 ± 1.2)
were elevated in diabetic patients (p=0.03).
Conclusion
Diabetes mellitus increases the risk of recurrent infections, impairs graft function, and alters immune
status, indicating the need for individualized monitoring and tailored immunosuppressive therapy.
status, indicating the need for individualized monitoring and tailored immunosuppressive therapy.
Keywords
kidney transplantation; diabetes mellitus; recurrent infections; immune status; CD4+; IL-6; TNF-α.0
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References
- 1. Afshar M., Rees M., Siddiqui M. Diabetes mellitus after kidney transplantation: impact on outcomes. Transplantation Reviews. 2020;34(3):100563.
- 2. Pasternak B., Wintzell V., Melbye M., Eliasson E., Hviid A. Diabetes and risk of infections after kidney transplantation. American Journal of Transplantation. 2021;21(4):1596–1606.
- 3. Helanterä I., Ekstrand A., Honkanen E., Kosola S., Kyllönen L., Lempinen M. Post-transplant infections in diabetic kidney recipients. Clinical Kidney Journal. 2020;13(5):789–797.
- 4. Bertoni A.G., Saydah S., Brancati F.L. Diabetes and immune dysfunction. Diabetes Care. 2020;43(8):1839–1846.
- 5. Hodgson K., Morris J., Bridson T., Govan B., Rush C., Ketheesan N. Immunological mechanisms contributing to the increased risk of infections in patients with diabetes mellitus. Clinical Microbiology Reviews. 2019;32(4):e00045-18.
- 6. Krohmals R., Larkin J., Hopkinson J., Martin P., Fernandez J., Bosco J. Pretransplant diabetes increases urinary tract infection risk in kidney allograft recipients. Journal of Clinical Medicine. 2025;14(2):618.
- 7. Liu S., Zhao Y., Wang L., Hu J., Shen Y., Zhang P. Infection burden in kidney transplant recipients: a multicenter analysis. Medicine Communications. 2024;5(2):e0669.
- 8. Fishman J.A. Infection in solid-organ transplant recipients. New England Journal of Medicine. 2020;382(25):2564–2575.