Renal transplantation in diabetic end-stage renal disease

Diabetes is a significant contributor for end-stage renal disease (ESRD). Apart from hemodialysis and peritoneal dialysis various forms of transplantation like renal transplantation, simultaneous pancreas kidney (SPK) transplantation and pancreas after kidney transplantation (PAK) are offered in eligible diabetic ESRD patients. Cardiovascular status determines survival outcomes predominantly. Any corrective cardiovascular intervention should be undertaken prior to transplantation. Survival outcomes are the best with transplantation in eligible diabetic ESRD patients when compared to their waitlisted counterparts. Microvascular and to some extent macrovascular complications are benefited by successful SPK or PAK although though benefited is appreciable after 5 years post transplantation.