Background. Treatment of diabetic ESRD determines a remarkable cost for Health siystems in industrialized nations. Aim of the present study was to analyze the results of hemodialysis, kidney and kidney-pancreas transplantation in terms of survival, mortality and morbidity; to perform a cost analysis; to assess cost-effectiveness. Methods. From January 1987 to December 1995, 131 diabetic uremic patients eligible for transplantation entered the renal replacement program at San Raffaele Hospital in Milan. Treatment groups were: hemodialysis (HD:48 pts), kidney transplantation (K:26 pts), kidney-pancreas transplantation (KP:57 pts). Results. Patients survival at 1,3 and 5 yrs, was respectively 75%, 64%, 55% for HD; 92% for K; 100%, 96%, 96% for KP. Mortality was 46% in HD; perioperative mortality was 8% for K and 1, 7% for KP, mortality during follow up 4% for K and 7% for KP. In HD 75% of patients registered morbidity requiring hospitalization. Surgical complications were 11% for K and 40% for KP, rejections were 67% and 66%, CMV infections 40% and 58%. Costs for one-year HD were US $43,120; transplantation costs were US $30,415 for K and US $44,280 for KP. Costs of every year after transplantation was US $12,930 for K and 10,740 for KP.
|Translated title of the contribution||Dialysis, kidney and kidney-pancreas transplantation. Results and costs in diabetic patients|
|Number of pages||9|
|Publication status||Published - 1997|
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