Events - ISN-TTS Webinar: Insulin dependent diabetes and CKD- kidney transplant alternatives, low resources setting

SPK (simultaneous pancreas-kidney transplant) is an established option for selected patients with T1DM and ESKD. We report a 34-year-old woman with long-standing T1DM, hypertension, dyslipidaemia and hypothyroidism, complicated by diabetic nephropathy progressing to ESKD, on twice-weekly haemodialysis for 2 years. Glycaemic and blood pressure control remained poor despite maximal medical therapy. She was evaluated for kidney transplantation with consideration of SPK due to insulin dependence and metabolic instability. Multidisciplinary assessment guided transplant strategy in this high-risk young patient.

This case illustrates the complex decision-making involved in transplant planning for young patients with long-standing type 1 diabetes mellitus complicated by end-stage kidney disease and multiple metabolic comorbidities. It highlights the clinical importance of considering simultaneous pancreas-kidney transplantation (SPK) in selected patients with insulin-dependent diabetes and poor glycaemic control despite optimal medical therapy. The case underscores the need for early referral and comprehensive multidisciplinary assessment to balance perioperative risk against long-term metabolic and renal benefits. Careful patient selection remains critical to optimizing outcomes and improving quality of life in this high-risk population.