Autosomal-dominant polycystic kidney disease as a risk factor for diabetes mellitus following renal transplantation

Mattos, Angelo M. de; Olyaei, Ali J.; Prather, Jonathan C.; Golconda, Muralikrishna; Barry, John M.; Norman, Douglas J.

doi:10.1111/j.1523-1755.2005.67132.x

Cited by 82 publications

(40 citation statements)

References 20 publications

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“…[14][15][16] Whether this association is due to an increased risk of maturity-onset diabetes of Table 2. Relationship between TCF7L2/HNF1β genotypes and NODAT RESEARCH the young (MODY) type 5 (also known as 'renal cyst and diabetes' syndrome) in this group of patients is worth exploring.…”

Section: Researchmentioning

confidence: 99%

New-onset diabetes after transplant: Incidence, risk factors and outcome

et al. 2017

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Background. The outcome of renal transplantation depends on achieving effective immunosuppression while minimising the consequences of such treatment. The occurrence of new-onset diabetes in the post-transplant period has been associated with several risk factors including some immunosuppressive medication. Better understanding of the clinical and genetic risk factors associated with new-onset diabetes after transplant (NODAT) could enable risk stratification of patients in the pre-transplant period, with the goal of applying measures that will reduce the incidence. Objectives. To ascertain the incidence of and clinical and genetic risk factors that predispose to NODAT, and to examine its effect on the outcome of renal transplantation. Methods. We performed a retrospective cohort review of all renal transplants at Groote Schuur Hospital, Cape Town, South Africa, between 2004 and 2008. Patients who were lost to follow-up or had pre-transplant diabetes or primary non-function were excluded. A subset of the cohort who gave informed consent was enlisted for genetic tests. Results. We identified 111 patients who met the inclusion criteria. The incidence of NODAT was 18.0% (n=20 patients). Risk factors for NODAT included age at transplant (p=0.03), body weight (p=0.04), treatment for acute cellular rejection (p=0.02) and polycystic kidney disease as the cause of renal failure (p=0.005). None of the genes investigated (TCF7L2 rs11196205, rs12255372 and rs7903146 and HNF1β rs1800575, rs121918671 and rs121918672) was found to be significantly associated with the risk of NODAT. The genotype frequencies for the single-nucleotide polymorphisms studied were closer (although not identical) to those reported for Caucasians than to those reported for the Yoruba (black) population in West Africa. Overall patient survival was 78% at five years, while graft survival was 72%. There was no significant difference in patient or graft survival between the group with NODAT and the group without. Conclusions. NODAT was common in renal transplant recipients. Some risk factors predate transplant and could be used to risk-stratify patients to determine appropriate risk-reduction strategies. The genetic determinants for NODAT in this population may differ from those reported elsewhere. NODAT had no impact on patient or graft survival in this cohort.

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Section: Researchmentioning

confidence: 99%

New-onset diabetes after transplant: Incidence, risk factors and outcome

et al. 2017

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“…Beyond hypertension, other metabolic abnormalities have also been reported to occur more frequently in ADPKD patients relative to a healthy control population, resulting in coronary artery disease [22]. Several articles have reported that ADPKD patients exhibit an increased incidence of post-transplant diabetes mellitus or new-onset diabetes after transplantation [23-25], indicating that an increased diabetogenic state arises due to ADPKD itself. HLA-B27 has been reported to be a potential risk factor for post-transplant diabetes mellitus in those with ADPKD [26].…”

Section: Discussionmentioning

confidence: 99%

Clinical Manifestation, Management and Prognosis of Acute Myocardial Infarction in Autosomal Dominant Polycystic Kidney Disease

Yang

Wang

et al. 2018

Kidney Blood Press Res

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Background/Aims: Cardiovascular complications are the most common cause of death in individuals with autosomal dominant polycystic kidney disease (ADPKD), yet there is no substantial data concerning the clinical characteristics of acute myocardial infarction (AMI) in this population. This study thus aimed to investigate AMI in persons with ADPKD. Methods: A retrospective analysis of ADPKD patients admitted to our hospital over a 13 year period was conducted. Age and gender-matched control patients without ADPKD were also selected at a ratio of 1: 10. Results: A total of 52 ADPKD and 520 non-ADPKD patients were enrolled in the present study, with those in the former group exhibiting significantly poorer kidney function. The distribution of AMI types differed significantly between these two groups. The incidence of ST-segment elevation myocardial infarction (STEMI) was higher (75.0%) and the incidence of non-ST segment elevation myocardial infarction (NSTEMI) was lower (25.0%) in the ADPKD group. At the onset of AMI, sudden cardiac death (SCD) was more common in ADPKD patients (11.5% vs. 4.6%). In terms of risk factors, the occurrence of hypertension was greater in ADPKD patients (78.8% vs. 39.6%). With regard to subsequent management, ADPKD patients had a higher prevalence of triple-branch coronary lesions (21.1% vs. 11.2%), undergoing more coronary artery bypass grafting (CABG) (7.7% vs. 5.4%) and fewer percutaneous coronary interventions (PCI) (73.1% vs. 84.6%). Overall, ADPKD patients had higher rates of mortality (13.5% vs. 6.2%). Conclusion: ADPKD patients with AMI suffer from more severe conditions and difficult therapies, resulting in a poorer prognosis.

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“…Autosomal dominant or recessive polycystic kidney disease is also linked to NODAT (ref. [16][17] ). A plausible mechanism for the association needs to be explained.…”

Section: Genetic Backroundmentioning

confidence: 99%

New-onset diabetes mellitus after renal transplantation

Goldmannová¹,

Karásek²,

Krystynik³

et al. 2016

BIOMED PAP

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Background and Aim. Diabetes mellitus is a very common metabolic disease with a rising incidence. It is both a leading cause of chronic renal disease and one of the most serious comorbidities in renal transplant recipients. New-onset diabetes after renal transplantation (NODAT) is associated with poor graft function, higher rates of cardiovascular complications and a poor prognosis. The aim of this paper is to review current knowledge of NODAT including risk factors, diagnosis and management. Methods. A MEDLINE search was performed to retrieve both original and review articles addressing the epidemiology, risk factors, screening and management of NODAT. We also focused on microRNAs as potential biomarkers of NODAT. Results and Conclusion. Understanding the risk factors (both modifiable-e.g. obesity, viruses, and unmodifiable-e.g. age, genetics) may help reduce the incidence and impact of NODAT using pre-and post-transplant management. This can lead to better long-term graft function and general transplant success.

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Autosomal-dominant polycystic kidney disease as a risk factor for diabetes mellitus following renal transplantation

Cited by 82 publications

References 20 publications

New-onset diabetes after transplant: Incidence, risk factors and outcome

New-onset diabetes after transplant: Incidence, risk factors and outcome

Clinical Manifestation, Management and Prognosis of Acute Myocardial Infarction in Autosomal Dominant Polycystic Kidney Disease

New-onset diabetes mellitus after renal transplantation

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