{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T08:25:05Z","timestamp":1759479905021,"version":"3.37.3"},"reference-count":25,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2017,6,5]],"date-time":"2017-06-05T00:00:00Z","timestamp":1496620800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000291","name":"Kidney Research UK","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000291","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet. Med."],"published-print":{"date-parts":[[2017,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To investigate whether people with diabetes have an elevated risk of kidney allograft rejection in a well characterized clinical cohort in the setting of contemporary immunosuppression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective cohort study including all kidney allograft recipients at a single centre between 2007 and 2015, linking clinical, biochemical and histopathological data from electronic patient records.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Data were analysed for 1140 kidney transplant recipients. The median follow\u2010up was 4.4 years post\u2010transplantation, and 117 of the kidney transplant recipients (10.2%) had diabetes at time of transplantation. Kidney allograft recipients with vs without diabetes were older (53 vs 45 years; <jats:italic>P<\/jats:italic>&lt;0.001) and more likely to be non\u2010white (41.0% vs 26.4%; <jats:italic>P<\/jats:italic>=0.001). Kidney allograft recipients with vs without diabetes had a higher risk of cellular rejection (19.7% vs 12.4%; <jats:italic>P<\/jats:italic>=0.024), but not of antibody\u2010mediated rejection (3.4% vs 3.7%; <jats:italic>P<\/jats:italic>=0.564). Graft function and risk of death\u2010censored graft loss were similar in the two groups, but kidney allograft recipients with diabetes had a higher risk of death and overall graft loss than those without diabetes. In a Cox regression model of non\u2010modifiable risk factors at time of transplantation, diabetes was found to be an independent risk factor for cellular rejection (hazard ratio 1.445, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.023\u20131.945; <jats:italic>P<\/jats:italic>=0.042).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Kidney allograft recipients with diabetes at transplantation should be counselled regarding their increased risk of cellular rejection but reassured regarding the lack of any adverse impact on short\u2010to\u2010medium term allograft function or survival.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dme.13383","type":"journal-article","created":{"date-parts":[[2017,5,16]],"date-time":"2017-05-16T16:06:29Z","timestamp":1494950789000},"page":"1067-1073","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Pre\u2010existing diabetes is a risk factor for increased rates of cellular rejection after kidney transplantation: an observational cohort study"],"prefix":"10.1111","volume":"34","author":[{"given":"S.","family":"Johal","sequence":"first","affiliation":[{"name":"School of Medicine University of Birmingham Birmingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F.","family":"Jackson\u2010Spence","sequence":"additional","affiliation":[{"name":"School of Medicine University of Birmingham Birmingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H.","family":"Gillott","sequence":"additional","affiliation":[{"name":"School of Medicine University of Birmingham Birmingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Tahir","sequence":"additional","affiliation":[{"name":"School of Medicine University of Birmingham Birmingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Mytton","sequence":"additional","affiliation":[{"name":"Department of Health Informatics Queen Elizabeth Hospital Birmingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F.","family":"Evison","sequence":"additional","affiliation":[{"name":"Department of Health Informatics Queen Elizabeth Hospital Birmingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B.","family":"Stephenson","sequence":"additional","affiliation":[{"name":"Department of Surgery Queen Elizabeth Hospital Birmingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Nath","sequence":"additional","affiliation":[{"name":"School of Medicine University of Birmingham Birmingham UK"},{"name":"Department of Nephrology and Transplantation Queen Elizabeth Hospital Birmingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7586-9136","authenticated-orcid":false,"given":"A.","family":"Sharif","sequence":"additional","affiliation":[{"name":"School of Medicine University of Birmingham Birmingham UK"},{"name":"Department of Nephrology and Transplantation Queen Elizabeth Hospital Birmingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,6,5]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"The Eighteenth Renal Registry Report 2015. Available athttps:\/\/www.renalreg.org\/reports\/2015-eighteenth-annual-report\/. Last accessed 4 September 2016."},{"key":"e_1_2_9_3_1","unstructured":"United States Renal Data System:2015Annual Data Report. Available athttps:\/\/www.usrds.org\/adr.aspx. 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