Kidney Transplant in Diabetic Patients: Risks, Results, Tips

Kidney transplant is the best treatment for those suffering from chronic kidney diseases, no matter if they have diabetes, high blood pressure, or other serious conditions. Diabetic patients can undergo this operation and increase the quality of their lives, even if they have other problems like cardiovascular diseases as well. However, compared to other patients, they need more attention, better management, and more careful follow-up care.

In this article, we specifically discuss kidney transplant in diabetic patients, and explain its risks, results, and post-op care.

How Does Diabetes Affect the Kidney?

In people with diabetes, blood sugar levels are high. This sugar produces harmful substances in the kidneys and weakens them. As a result, the glomeruli (filtering units in the kidneys) are damaged, and albumin (a type of protein made by the liver) leaks into the urine. High blood sugar also binds glomerular proteins together and creates small scars inside the kidneys. All these problems reduce the kidney’s capacity and damage it for good. Note that these problems can happen both before and after a kidney transplant, but their risks and likelihood are not the same.

Studies show that kidney problems happen in 82.9% of diabetic patients before a transplant, but this number is reduced to 57.1% after the surgery. In simpler words, the risk of kidney failure is lower after transplantation.

However, some non-diabetic people may also develop kidney problems after the surgery. To be more precise, almost 21% of patients face kidney problems after the surgery, even if they don’t have diabetes. In sum, there is a close connection between diabetes and kidney health, and each one can affect the other.

How to Keep Your Kidneys Healthy When You Have Diabetes

Having a balanced diet is important for everyone, but it’s crucial for diabetic people. A healthy diet can keep the kidneys healthy and balance the blood sugar and blood pressure. After a kidney transplant, diabetic patients should consider the following points to keep their kidneys from damage:

• Reducing sodium, salt, potassium, and phosphorus intake.
• Drinking enough water throughout the day.
• Taking prescribed medications exactly as instructed.
• Avoiding taking NSAIDs (even the OTC ones) without doctors’ approval.
• Treating infections only through the doctor’s instructions because the immune system is suppressed by anti-rejection drugs.
• Getting regular medical tests and checkups so the doctor can detect and treat diseases in time.
• Using home blood pressure monitors and blood glucose meters (glucometers) daily.

Signs of Kidney Failure in Diabetic People

In people with diabetes, kidney diseases usually have no apparent symptoms in the early stages, especially if the problem is only microalbuminuria. As the kidney problem gets worse, different symptoms may appear, such as feeling exhausted, having less energy than usual, dry and itchy skin, muscle cramps (especially in the legs), swelling in the legs, puffiness around the eyes, pale skin, frequent urination, morning sickness, high blood urea nitrogen (BUN) levels, and high creatinine levels in blood.

To diagnose kidney disease in people with diabetes, doctors measure the albumin level in their urine. Having more albumin than creatinine means there is a risk of kidney disease. Of course, there should be no other cause for a high level of albumin in the urine. 

Kidney Transplant in Diabetic Patients

As mentioned earlier, kidney transplantation is the best treatment for people with chronic kidney failure, whether they have diabetes or not. Studies show that about 30% of people with type 1 diabetes and 40% of people with type 2 diabetes will eventually lose one or both kidneys as they age.

Kidney transplant surgery is a safe procedure for people with diabetes. This operation is performed by skillful nephrologists in Iran and many other countries around the world. It’s worth mentioning that after a kidney transplant, the doctor may increase the insulin dose because the new kidney works better than the damaged one and breaks down insulin better.

Kidney Transplant Post-op Care: for Patients with Diabetes

After a kidney transplant, people with diabetes must follow all post-op care instructions. This includes taking medications exactly as prescribed, drinking enough water, avoiding bending, avoiding lying on the belly, and having a healthy lifestyle. Moreover, people with diabetes should control their blood sugar and pressure. The glucose level should be checked using an HbA1c (A1C) test, because it shows the average blood sugar level over the past three months. Blood pressure should stay below 140/90 mmHg, or 130/80 mmHg in some patients.

Doctors usually recommend a combination of diet, medications, and exercise to control blood sugar and pressure. Patients must follow all these instructions to protect the transplanted kidney and stay healthy.

Success Rate of Kidney Transplant in Diabetic Patients

Fortunately, the success rate of kidney transplant in people with diabetes is high. According to a study:

• The survival rate of the transplanted kidney is about 68.5% in diabetic patients and about 91% in non-diabetic patients.
• For patients who develop diabetes after the transplant (PTDM), the survival rate of the transplanted kidney is around 77%.
• 82.8% of people with diabetes and 97.1% of non-diabetic patients stay alive and healthy after the kidney transplant surgery.

Kidney Transplant in Diabetic Patients: Diet and Medication

After a kidney transplant, it is important to follow a healthy diet and take medication on time. Here are 8 useful tips for people with diabetes:

1. Fruits, vegetables, healthy fats, and lean protein should be added to your daily meals.
2. The amount of potassium, phosphorus, and protein you take must be controlled.
3. You should eat less meat, beans, dairy products, nuts, whole-grain bread, tomatoes, and oranges.
4. To follow a balanced and healthy diet, get help from a registered dietitian.
5. Take all the prescribed medications exactly as directed and avoid taking new drugs without your doctor’s approval.
6. You are not allowed to use painkillers or NSAIDs without your doctor’s permission.
7. Take immunosuppressants to prevent kidney failure.
8. Take medicines to control hyperglycemia and hypertension.

Note that some blood pressure medicines also keep the kidneys from failing. For example, ACE inhibitors and ARBs (such as Lisinopril, Losartan, and Candesartan) both lower the blood pressure and help the kidneys work properly.

A Quick Review

People with diabetes can also undergo a kidney transplant if they suffer from chronic kidney failure. This surgery is totally safe for them and can help them have a normal, high-quality life. The same applies to diabetic patients who have a kidney transplant in Iran: the survival rate of their new kidney is high, just like in non-diabetic patients.

Plus, the majority of kidney transplant surgeries are successful, so their life expectancy is quite high. However, after the transplant, diabetic patients should be more careful with what they eat, their activities, and their medications.

Get a free consultation, precise treatment planning, dedicated support, and a personalized medical travel roadmap. Contact the experts at Iran health agency today.

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FAQs

Which one is better for diabetic patients, dialysis or a kidney transplant?

Kidney transplant is a better treatment for chronic kidney failure compared to dialysis, only if the patient doesn’t have severe heart or cardiovascular diseases.

Can I use insulin after a kidney transplant?

Insulin itself cannot damage the transplanted kidney. In fact, you should keep the blood sugar under control to protect the kidneys, whether with insulin or other methods.