Type I end stage renal disease (ESRD) diabetics no longer have to be considered a special high-risk category of patients for kidney transplantation that, on the contrary, should be regarded as the therapy of choice. Nevertheless, the diabetic syndrome requires a different approach to these patients because of the number and the severity of the complications and the general brittleness of such patients. Some criteria for selection of patients in view of a kidney transplantation should have been assumed on the basis of a detailed assessment of the diabetic complications with special regard to the cardiovascular system. In fact, the predictability of cardiac and vascular complications is not sufficiently precise on the bases of the usual noninvasive investigations. However, the risk factors of transplantation must not be considered as absolute, but should be balanced with those of each of the alternative therapies; in addition, the better quality of life, the major autonomy, the artificial organ independence, and the recovered feeling of well-being, with all of the psychological implications obtainable in the cases of successful transplants, must also be carefully considered. On these bases, we believe that transplantation is reasonably proposable to almost the whole population of type I ESRD diabetics, but we are equally convinced of the need of standardized criteria for patient assessment and selection, perhaps established by an 'ad hoc' committee.
|Number of pages||6|
|Publication status||Published - 1984|
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