Abstract:

BACKGROUND: With application of immunosuppressants, endocrine, saccharide and lipid metabolism change in recipients after renal transplantation. Diabetic ketoacidosis has become a serious complication that affects short- and long-term survival rate, directly affect transplant outcomes after renal transplantation.  
OBJECTIVE: To analyze the relative onset factors of diabetic ketoacidosis after renal transplantation, and to summarize the cure methods in order to decrease death rate.
METHODS: Clinical data of 18 cases with diabetic ketoacidosis after renal transplantation from 2003 to 2009 were retrospective analyzed, including 2 cases with type 2 diabetes history, and 16 cases without diabetes history. The ketosis occurred from 3 days to 2.5 years after transplantation, with early clinical manifestation of fatigue, anorexa, muscular soreness or fever. Dehydration and neurological symptoms appeared with development of pathogenetic condition. Treatments, such as small-dose insulin medication and fluid infusion, were used to correct disturbances of electrolyte and acid-base. The inducement was removed.
RESULTS AND CONCLUSION: Thirteen cases were cured, with 72% success ratio. Three cases died, 1 for septic shock and 2 for multiple organ failure, with 17% case fatality rate. Two cases were successful rescued, but lost the function of transplant kidney and returned to hemodialysis. The findings demonstrated that, diabetic ketoacidosis is a complication that closely associates with anti-rejection drugs and transplanted kidney functions after transplantation. The clinical manifestation of diabetic ketoacidosis is untypical, but it leads to serious consequence if treated inappropriate, accordingly, it should be attracted great attention.