{"id":2913,"date":"2026-09-06T17:03:21","date_gmt":"2026-09-06T17:03:21","guid":{"rendered":"https:\/\/bookinghospital.org\/?p=2913"},"modified":"2026-09-06T17:29:15","modified_gmt":"2026-09-06T17:29:15","slug":"kidney-transplant-with-diabetes","status":"publish","type":"post","link":"https:\/\/bookinghospital.org\/pl\/kidney-transplant-with-diabetes\/","title":{"rendered":"Kidney Transplant with Diabetes"},"content":{"rendered":"<div data-elementor-type=\"wp-post\" data-elementor-id=\"2913\" class=\"elementor elementor-2913\">\n\t\t\t\t<div class=\"elementor-element elementor-element-6f64773 e-con-full e-flex e-con e-parent\" data-id=\"6f64773\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-bf3ea1f elementor-widget elementor-widget-html\" data-id=\"bf3ea1f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"html.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\n<div id=\"bh\">\n\n<section class=\"hero\">\n  <div class=\"in\">\n    <p class=\"eyebrow\">Kidney transplantation \u00b7 Before the transplant<\/p>\n    <h1>Diabetes is not a reason to wait. It is a reason to hurry.<\/h1>\n    <p class=\"lead\">Diabetic patients are often quietly moved to the back of the queue. The\n       evidence points the other way: they are the group who gain the most from a\n       transplant \u2014 and lose the most by waiting.<\/p>\n    <p class=\"meta\">Written by <b style=\"color:#fff\">Profesor dr Murat Tuncer<\/b> \u00b7\n       Adapted from his book <i>Przeszczep nerek \u2014 z pytaniami i odpowiedziami<\/i><\/p>\n  <\/div>\n<\/section>\n\n<section class=\"wrap\">\n\n  <div class=\"ozet\">\n    <h2>The short answer<\/h2>\n    <ul>\n      <li><b>Yes \u2014 diabetes does not disqualify you<\/b> from a kidney transplant, whether\n          type 1 or type 2.<\/li>\n      <li>Diabetic patients are the group who <b>may see the greatest benefit<\/b> from\n          transplantation.<\/li>\n      <li>Expected gain in life expectancy is around <b>10 years<\/b>, and considerably more\n          in some groups.<\/li>\n      <li>The conversation should begin when eGFR falls <b>below 30<\/b>, and move quickly\n          below <b>20<\/b>.<\/li>\n      <li>The real risk is not the transplant. It is the <b>time spent waiting<\/b> for one.<\/li>\n    <\/ul>\n  <\/div>\n\n  <h2>Why this question comes up so often<\/h2>\n\n  <p>Diabetes is the leading cause of chronic kidney disease worldwide, and its prevalence is\n     still rising. Roughly <b>40% of patients with end-stage renal disease<\/b> reached that\n     point through diabetes-related deterioration of kidney function.<\/p>\n\n  <p>In the United States, the rate of kidney failure caused by diabetes rose by <b>30%<\/b>\n     between 1992 and 2008. This is not a small subgroup of dialysis patients. In many units\n     it is the largest one.<\/p>\n\n  <p>Which makes it worth asking why so many diabetic patients are told, in one form or\n     another, to wait.<\/p>\n\n  <h2>What the evidence actually shows<\/h2>\n\n  <p>Type 1 and type 2 diabetics are the group of patients who <b>may see the most benefit\n     from a kidney transplant<\/b>. That is the opposite of how the question is often framed.<\/p>\n\n  <div class=\"box\">\n    <span class=\"etiket\">The numbers<\/span>\n    <p>The predicted increase in life expectancy from kidney transplantation is around\n      <b>10 years<\/b> \u2014 particularly in the diabetic population, whose prognosis on dialysis\n      is poor.<\/p>\n    <p>A decision-analysis model published in 2003, examining type 1 diabetic patients\n      specifically, found that <b>living donor kidney transplantation allowed patients to live\n      18 years longer<\/b>.<sup>1<\/sup><\/p>\n  <\/div>\n\n  <p>That transplantation is better than dialysis for both quality of life and survival is, in\n     this population, not seriously disputed.<\/p>\n\n  <h2>The cost of waiting<\/h2>\n\n  <p>This is the part that rarely gets said plainly, so it is worth stating without softening.<\/p>\n\n  <div class=\"box efsane\">\n    <span class=\"etiket\">Put directly<\/span>\n    <p>Keeping diabetic patients away from kidney transplantation means accepting that\n      <b>50% of them will die within two years<\/b>, and <b>80% within five<\/b>.<\/p>\n    <p>Every month of delay is drawn from that timeline. Caution is not neutral here \u2014 it has\n      a cost, and the cost is measured in survival.<\/p>\n  <\/div>\n\n  <p>Set against this, the risks that lead to hesitation \u2014 surgical risk, the burden of\n     immunosuppression, cardiovascular complications \u2014 are real but comparatively modest. They\n     have to be weighed against what happens if nothing is done, and that comparison usually\n     favours transplantation.<\/p>\n\n  <div class=\"soru\">\n    <h3>When should a diabetic patient start the transplant conversation?<\/h3>\n\n    <p>Earlier than most people are told.<\/p>\n\n    <div class=\"tblwrap\">\n      <table>\n        <thead>\n          <tr><th>Kidney function (eGFR)<\/th><th>What should be happening<\/th><\/tr>\n        <\/thead>\n        <tbody>\n          <tr>\n            <td><b>Below 30 mL\/min<\/b><\/td>\n            <td>Type 1 diabetic patients should <b>begin the information and decision-making\n              process<\/b> \u2014 learning the options, identifying a potential living donor,\n              starting the workup<\/td>\n          <\/tr>\n          <tr>\n            <td><b>Below 20 mL\/min<\/b><\/td>\n            <td>That process should <b>accelerate<\/b>. This is the window in which a transplant\n              before dialysis is still possible<\/td>\n          <\/tr>\n          <tr>\n            <td>Already on dialysis<\/td>\n            <td>Still a candidate \u2014 but the advantage of pre-emptive transplantation has\n              passed<\/td>\n          <\/tr>\n        <\/tbody>\n      <\/table>\n    <\/div>\n\n    <p>If your eGFR is under 30 and no one has raised transplantation with you, that is a\n       question worth asking at your next appointment.<\/p>\n  <\/div>\n\n  <div class=\"soru\">\n    <h3>Does my diabetes need to be well controlled first?<\/h3>\n\n    <p>Good glycaemic control matters, before and after transplantation \u2014 but \"get your diabetes\n       under control first\" should not become an open-ended delay.<\/p>\n\n    <p>A target HbA1c around <b>7.0%<\/b> is generally recommended to prevent or slow progression\n       of diabetic kidney disease. That target is deliberately not pushed lower in patients at\n       risk of hypoglycaemia, where tight control carries its own danger.<\/p>\n\n    <p>The practical question to ask is not \"is my control perfect?\" but <b>\"is my control good\n       enough to proceed, and what specifically would need to change?\"<\/b> A clear answer means\n       progress. A vague one usually means delay.<\/p>\n  <\/div>\n\n  <div class=\"soru\">\n    <h3>Are the medications after transplant a problem for a diabetic?<\/h3>\n\n    <p>They require management rather than exclusion. Immunosuppressive drugs \u2014 steroids in\n       particular \u2014 affect blood sugar, and diabetes can also appear for the first time after\n       transplantation in patients who did not have it before.<\/p>\n\n    <p>This is anticipated, monitored and treated. It is a reason for careful follow-up, not a\n       reason to withhold a transplant from someone whose alternative is dialysis.<\/p>\n  <\/div>\n\n  <h2>What this means in practice<\/h2>\n\n  <ul>\n    <li><b>Diabetes is not a contraindication.<\/b> If you have been refused, establish what the\n        stated reason actually was \u2014 it may have been something else entirely.<\/li>\n    <li><b>A living donor changes the arithmetic.<\/b> The 18-year figure above came from living\n        donor transplantation specifically.<\/li>\n    <li><b>Timing is the variable you can still influence.<\/b> Eligibility rarely improves with\n        waiting; the patient's condition often worsens.<\/li>\n  <\/ul>\n\n  <div class=\"yazar\">\n    <div class=\"rozet\">MT<\/div>\n    <div>\n      <h3><a href=\"https:\/\/bookinghospital.org\/pl\/murat-tuncer-md\/\" style=\"color:inherit\">Profesor dr Murat Tuncer<\/a><\/h3>\n      <p>Nephrologist and transplant physician. Author of <i>Kidney Transplantation \u2014 With\n        Questions and Answers<\/i> (Istanbul, 2020), written to answer the questions his own\n        patients ask most often.<\/p>\n    <\/div>\n  <\/div>\n\n  <div class=\"cta\">\n    <h2>Find out where you actually stand<\/h2>\n    <p>Send us your recent kidney function tests, HbA1c and any transplant assessment you have\n       already had. We will tell you honestly whether transplantation is realistic \u2014 and how\n       urgent it is.<\/p>\n    <div class=\"btns\">\n      <a class=\"btn btn-1\" href=\"https:\/\/bookinghospital.org\/pl\/medyczny-turystyka\/\">Prze\u015blij swoje raporty medyczne<\/a>\n      <a class=\"btn btn-2\" href=\"\/pl\/category\/kidney-transplant-guide\/\">More patient guides<\/a>\n    <\/div>\n  <\/div>\n\n  <div class=\"uyari\">\n    <p><b>Wykluczenie odpowiedzialno\u015bci medycznej.<\/b> This article is general information adapted from a published\n      book. It is not personal medical advice, it does not establish a doctor\u2013patient\n      relationship, and it cannot replace assessment by the physician treating you. Treatment\n      targets and transplant criteria differ between patients and between centres. Always\n      consult your own nephrologist or transplant centre before making decisions about your\n      treatment.<\/p>\n  <\/div>\n\n  <div class=\"kaynak\">\n    <h3>References<\/h3>\n    <ol>\n      <li>Knoll G, Nichol G. Dialysis, kidney transplantation or pancreas transplantation for\n        patients with diabetes mellitus and renal failure: a decision analysis of treatment\n        options. <i>J Am Soc Nephrol<\/i> 2003;14:500\u201315.<\/li>\n      <li>United States Renal Data System. Annual Data Report \u2014 incidence, prevalence, patient\n        characteristics and treatment modalities.<\/li>\n      <li>Turkish Society of Endocrinology and Metabolism. Diagnosis, treatment and follow-up\n        guide for diabetes mellitus and its complications, 2013.<\/li>\n      <li>Knoll G, Cockfield S, Blydt-Hansen T, et al. Canadian Society of Transplantation\n        consensus guidelines on eligibility for kidney transplantation.\n        <i>CMAJ<\/i> 2005;173(10).<\/li>\n    <\/ol>\n  <\/div>\n\n<\/section>\n\n<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"<p>Kidney transplantation \u00b7 Before the transplant Diabetes is not a reason to wait. It is a reason to hurry. Diabetic patients are often quietly moved to the back of the queue. The evidence points the other way: they are the group who gain the most from a transplant \u2014 and lose the most by waiting. [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"elementor_header_footer","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"set","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"_joinchat":[],"footnotes":""},"categories":[16],"tags":[],"class_list":["post-2913","post","type-post","status-publish","format-standard","hentry","category-kidney-transplant-guide"],"_links":{"self":[{"href":"https:\/\/bookinghospital.org\/pl\/wp-json\/wp\/v2\/posts\/2913","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/bookinghospital.org\/pl\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/bookinghospital.org\/pl\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/bookinghospital.org\/pl\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/bookinghospital.org\/pl\/wp-json\/wp\/v2\/comments?post=2913"}],"version-history":[{"count":4,"href":"https:\/\/bookinghospital.org\/pl\/wp-json\/wp\/v2\/posts\/2913\/revisions"}],"predecessor-version":[{"id":2918,"href":"https:\/\/bookinghospital.org\/pl\/wp-json\/wp\/v2\/posts\/2913\/revisions\/2918"}],"wp:attachment":[{"href":"https:\/\/bookinghospital.org\/pl\/wp-json\/wp\/v2\/media?parent=2913"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/bookinghospital.org\/pl\/wp-json\/wp\/v2\/categories?post=2913"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/bookinghospital.org\/pl\/wp-json\/wp\/v2\/tags?post=2913"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}