Effects of preoperative hepatitis B virus infection, hepatitis C virus infection, and coinfection on the development of new‐onset diabetes after kidney transplantation

Liang, Jing; Lv, Chaoyang; Chen, Minling; Xu, Ming; Zhao, Chengcheng; Yang, Yibing; Wang, Jina; Zhu, Dong; Gao, Xin; Rong, Ruiming; Zhu, Tongyu; Yu, Mi

doi:10.1111/1753-0407.12853

Cited by 8 publications

(4 citation statements)

References 45 publications

(99 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…52 In the present study, we observed that there was a significantly higher prevalence of patients with chronic HCV infection in the PTDM group, especially among cases with the AT genotype (Tables 1 and 4). This finding was in accordance with previous studies that highlighted chronic HCV as a risk factor for PTDM. 53 There was a significantly higher prevalence of AA and AT genotypes in the PTDM group ( p =0.05 and 0.007, respectively), especially in those with HCV infection (Table 4).…”

Section: Discussionsupporting

confidence: 92%

<p>Immunogenetics of new onset diabetes after transplantation in Kuwait</p>

Jahromi

Al-Otaibi²,

Othman

et al. 2019

DMSO

View full text Add to dashboard Cite

Introduction and aim: New onset diabetes after transplantation (NODAT) is a serious metabolic complication following kidney transplantation. Although beta-cell dysfunction is considered the main contributing factor in the development of this complication, its exact etiology is yet to be identified. We aimed to investigate NODAT among kidney transplant cohort in Kuwait with special stress on correlation between its risk factors and interferon gamma genotyping. Materials and methods: We surveyed 309 kidney transplant recipients from Hamed Al Essa Transplantation Centre, Kuwait. The participants were categorized into cohorts according to the development of NODAT diagnosed based on the American Diabetes Association guidelines. Statistical analyses were performed using SPSS software. We genotyped interferon gamma as the leading immunosignature for T lymphocyte. Results: No relationship between ethnicity and the development of NODAT was identified. However, there was a significant difference in age between cohorts. Younger patients demonstrated a lower rate of NODAT while, NODAT reached its maximum in 40–60-year age group. IFNG TT genotype was significantly associated with NODAT ( p =0.005), while IFNG AA was considerably higher in the non-NODAT group. Conclusion: Beside the conventional contributing factors of NODAT, our results might represent a suitable platform for a larger cytokine and chemokine spectrum genotyping.

show abstract

Section: Discussionsupporting

confidence: 92%

<p>Immunogenetics of new onset diabetes after transplantation in Kuwait</p>

Jahromi

Al-Otaibi²,

Othman

et al. 2019

DMSO

View full text Add to dashboard Cite

show abstract

“…As for pre-transplant diabetes, the prevalence of AGM (10.7%) or NODAT (12.6%) among our KT recipients was lower than that reported in the literature (> 20%) [12,13,37]. Such reassuring results may be partially due to the favorable baseline characteristics of the patients enrolled [38], mostly Caucasian [39,40], young [9,40], non-obese (mean BMI, 23) [40], and without a history of chronic HBV (3.3%) or HCV (6.7%) [41] infection. However, other variables may have played a role, such as the preferred use of cyclosporine over tacrolimus in recipients at increased risk of NODAT [42,43], routine application of CNIminimization protocols [44], paucity of patients receiving mTORi (<3%) [45], relatively low doses of steroid administered at induction (≤750 mg) [46], frequent (twice weekly) CMV viremia assessment during the early post-transplant phase [17], dedicated counselling for optimal weight control after transplant [47], and aggressive outpatient monitoring for hypertension [48], lipid disorders [44], magnesium [16], or vitamin D deficiency [9].…”

Section: Discussionsupporting

confidence: 43%

“…In particular, familial predisposition to diabetes [9], older age [50], and higher BMI [51] have been consistently reported as important contributing factors. On the contrary, less clear remain the possible relationships between NODAT and autosomal polycystic kidney disease [52], HCV [53], or HBV infection [41].…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Risk Factors of Abnormal Glucose Metabolism and New-Onset Diabetes Mellitus after Kidney Transplantation: A Single-Center Retrospective Observational Cohort Study

et al. 2022

View full text Add to dashboard Cite

Background and objectives: New-onset diabetes after transplantation (NODAT) represents a primary cause of morbidity and allograft loss. We assessed prevalence and risk factors for NODAT in a population of Italian kidney transplant (KT) recipients. Methods: Data from 522 KT performed between January 2004 and December 2014 were analyzed. Participants underwent clinical examination; blood and urine laboratory tests were obtained at baseline, one, six, and 12-month of follow-up to detect glucose homeostasis abnormalities and associated metabolic disorders. An oral glucose tolerance test (OGTT) was performed at six months in 303 subjects. Results: Most patients were Caucasian (82.4%) with a mean age of 48 ± 12 years. The prevalence of abnormal glucose metabolism (AGM) and NODAT was 12.6% and 10.7%, respectively. Comparing characteristics of patients with normal glucose metabolism (NGM) to those with NODAT, we found a significant difference in living donation (16.6% vs. 6.1%; p = 0.03) and age at transplant (46 ± 12 vs. 56 ± 9 years; p = 0.0001). Also, we observed that patients developing NODAT had received higher cumulative steroid doses (1-month: 1165 ± 593 mg vs. 904 ± 427 mg; p = 0.002; 6-month:2194 ± 1159 mg vs. 1940 ± 744 mg; p = 0.002). The NODAT group showed inferior allograft function compared to patients with NGM (1-year eGFR: 50.1 ± 16.5 vs. 57 ± 20 mL/min/1.73 m2; p = 0.02). NODAT patients were more likely to exhibit elevated systolic blood pressure and higher total cholesterol and triglyceride levels than controls. Conclusions: The prevalence of NODAT in our cohort was relatively high. Patient age and early post-transplant events such as steroid abuse are associated with NODAT development.

show abstract

“…Pre-transplant chronic HCV infection (p = 0.023) and cyclosporine use (p = 0.024) were the most significant predictors of PTDM. In a retrospective cohort of 557 renal transplant recipients from China, HCV infection was associated with a 3.03-fold risk of PTDM on multivariate analysis [ 15 ]. In a meta-analysis involving 2,502 renal transplant recipients from 10 studies, a strong association was found between pre-transplant anti-HCV antibody positivity and PTDM with an adjusted HR of 3.97 [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Predictors of Short-Term Outcomes in Living Donor Renal Allograft Recipients: A Prospective Study From a Tertiary Care Center in North India

John¹,

Mehta²,

Sohal³

et al. 2022

Cureus

View full text Add to dashboard Cite

BackgroundRenal transplantation is the optimal treatment for patients of all ages with end-stage kidney disease. The long-term outcomes of renal transplantation are assessed by graft and patient survival rates. These outcomes are, in turn, influenced by post-transplant events such as delayed graft function, rejections, posttransplant infections, and post-transplant diabetes mellitus (PTDM). Each of these short-term outcomes is, in turn, determined by the interplay of various factors in the pre-, peri-, and post-transplant period. This prospective study was designed to understand the factors affecting short-term outcomes in living donor transplantation and their effect on graft and patient survival. MethodologyA total of 86 patients underwent live donor renal transplantation between January 1, 2015, and March 31, 2016, at a tertiary care hospital in north India. Of these, five were lost to follow-up, and the remaining 81 patients were prospectively followed up to December 31, 2017. ResultsThe majority of the recipients were males (91%) and the donors were females (74%). Spousal and related donors comprised 49% and 51% of donations, respectively. The mean estimated glomerular filtration rate (eGFR) of donors was 98 ± 9.2 mL/minute/1.73m². Induction therapy with basiliximab was given to 21/81 (26%) recipients. The majority of recipients (68/81, 84%) received triple-drug immunosuppression with prednisolone, tacrolimus, and mycophenolate mofetil. Delayed graft function (DGF) occurred in 4/81 (4.9%) cases. Biopsy-proven acute rejections (BPARs) occurred in 15/81 (18.5%) cases, two-thirds of which were acute antibody-mediated rejections (ABMRs). During the follow-up period, 50 episodes of infections occurred in 35/81 (43.2%) recipients, with the most common being urinary tract infection (23/81, 28.5%). PTDM was diagnosed in 22/81 (27.2%) patients beyond six weeks of transplant. On multivariate logistic regression analysis, the most significant predictor of DGF was acute rejections and vice versa. Acute rejections also predicted the occurrence of post-transplant infections. Pre-transplant hepatitis C virus (HCV) infection and cyclosporine-based therapy were significant predictors of PTDM. At the six-month follow-up, 10/81 (12.3%) patients developed graft dysfunction. The predictors of graft dysfunction at six months were recipients of related donors and rural patients. One-year graft survival, death-censored graft survival, and patient survival rates were 85.2%, 92.6%, and 91.3%, respectively. The most common cause of death was post-transplant infections (5/7, 71.4%) of which the majority (4/5, 80%) were fungal infections. On multivariate logistic regression analysis, the most significant predictor of graft loss and patient loss was low pre-transplant donor eGFR and PTDM, respectively. ConclusionsGraft and patient survival in living donor kidney transplantation are influenced by a multitude of interdependent factors during the pre-transplant (donor eGFR, type of donor, socioeconomic status, HCV infection in recipient, ty...

show abstract

Effects of preoperative hepatitis B virus infection, hepatitis C virus infection, and coinfection on the development of new‐onset diabetes after kidney transplantation

Abstract: Preoperative HCV infection significantly increased the risk of NODAT in Chinese KTRs, whereas HBV infection and HBC + HCV coinfection were not correlated with NODAT development.

Cited by 8 publications

References 45 publications

<p>Immunogenetics of new onset diabetes after transplantation in Kuwait</p>

<p>Immunogenetics of new onset diabetes after transplantation in Kuwait</p>

Prevalence and Risk Factors of Abnormal Glucose Metabolism and New-Onset Diabetes Mellitus after Kidney Transplantation: A Single-Center Retrospective Observational Cohort Study

Predictors of Short-Term Outcomes in Living Donor Renal Allograft Recipients: A Prospective Study From a Tertiary Care Center in North India

Contact Info

Product

Resources

About