Incidence and Risk Factors for Post–Renal Transplant Diabetes Mellitus

Ali, I. Hadj; Adberrahim, Ezzedine; Abdelghani, K. Ben; Barbouch, S.; Mchirgui, N.; Khiari, K.; Cherif, Mejda; Ounissi, M.; Romhane, N. Ben; Abdallah, N. Ben; Abdallah, T. Ben; Maı̈z, H. Ben; Khedher, A.

doi:10.1016/j.transproceed.2011.01.032

Cited by 13 publications

(3 citation statements)

References 20 publications

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“…Age is considered as an important risk factor for NODAT, especially in patients >40 years, as described in various studies. [30][31][32] We too observed that the patients who developed diabetes were comparatively older (39.83 ± 10.21) than the patients who did not develop diabetes after renal transplantation (34.78 ± 8.59) which AUC: Area under the curve, NODAT: New-onset of diabetes after transplantation, HC: Healthy controls was consistent with various studies in different population. Similar results were observed in NODAT (39.3 ± 13.4) versus non-NODAT (33.9 ± 11.8) in Malaysian population.…”

Section: Discussionsupporting

confidence: 88%

Assessment of Biochemical Parameters, Kidney Function, and Long-term Outcome in Renal Transplant Recipients

Ahmad¹,

Kesiraju²,

Reddy³

et al. 2022

APJHS

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Background and Aims: New-onset of diabetes after transplantation (NODAT) is the most significant complications arising post-renal transplantation and affecting the long-term graft outcome and recipient survival. Assessment of renal function in kidney transplant recipients might help in understanding the better outcome of the graft and also the factors associated with NODAT. The present study was aimed to estimate the biochemical parameters, electrolytes, and minerals in the serum among renal transplant recipients and healthy controls (HC) and to evaluate the graft function, graft outcome and patient survival. Materials and Methods: Biochemical parameters (creatinine, urea, and uric acid), electrolytes (sodium, potassium, and chloride), and minerals (calcium and phosphorus) were estimated in serum by enzymatic method using commercially available kits in 100 HC, 80 NODAT, and 80 Non-NODAT subjects. The graft outcome was assessed by comparing serum creatinine levels and urinary creatinine clearance at 0 month and 60 months. The survival rate was evaluated by Kaplan-Meier survival curve. Results: The mean age was significantly higher in NODAT versus non-NODAT at P < 0.0009. Significant gender difference was observed in NODAT and non-NODAT versus HC at P < 0.0001. The levels of creatinine, urea, and uric acid were significantly more in NODAT versus HC at P < 0.0001, P < 0.0001, and P < 0.006. The mean levels of sodium and phosphorus were significantly lower in NODAT versus HC at P < 0.008 and P < 0.029. In multinomial logistic regression analysis, age, male gender, creatinine, and urea significantly predicted the outcome and the Receiver Operating Characteristic analysis revealed creatinine to be better marker for assessing kidney function. The Kaplan-Meier survival curve analysis showed decreased survival rates in NODAT than non-NODAT. Conclusion: Older age (above 40), hyponatremia, and hypophosphatemia could be significant risk factors for NODAT development.

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Section: Discussionsupporting

confidence: 88%

Assessment of Biochemical Parameters, Kidney Function, and Long-term Outcome in Renal Transplant Recipients

Ahmad¹,

Kesiraju²,

Reddy³

et al. 2022

APJHS

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“…The reported incidence of NODAT mostly ranged from 2% to 50%. 5,[16][17][18][19][20][21][22] The wide variation in the incidence rate is due to the differences in diagnostic criteria, the duration of follow-up, presence of risk factors, the type of organ transplants, and immunosuppressive treatment used in the studies. 23 Data from the US Renal Data System (USRDS) and a French study showed 16% and 18% incidences of NODAT at year 1 of transplantation, respectively.…”

Section: Discussionmentioning

confidence: 99%

New-Onset Diabetes After Kidney Transplantation and Pretransplant Hypomagnesemia

et al. 2016

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“…However, outcomes are compromised by long-term complications such as diabetes, obesity, and de novo/recurrent fatty liver disease that put patients at higher risk of cardiovascular disease 1 . In particular, new-onset diabetes mellitus after transplant (NODAT) occurs in a large proportion of patients, with estimates ranging from 17–53% 1 , 2 . Immunosuppressive therapy is a key risk factor for NODAT, in addition to age, family history, and ethnicity 1 .…”

Section: Introductionmentioning

confidence: 99%

Impact of Immunosuppression on the Metagenomic Composition of the Intestinal Microbiome: a Systems Biology Approach to Post-Transplant Diabetes

Bhat

Pasini

Copeland

et al. 2017

Sci Rep

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Solid organ transplantation (SOT) outcomes have continued to improve, although long-term use of immunosuppressants can lead to complications such as diabetes, compromising post-transplant outcomes. In this study, we have characterized the intestinal microbiome (IM) composition at the metagenomic level in the context of hyperglycemia induced by immunosuppressants. Sprague-Dawley rats were subjected to doses of tacrolimus and sirolimus that reliably induce hyperglycemia and an insulin-resistant state. Subsequent exposure to probiotics resulted in reversal of hyperglycemia. 16S rRNA and metagenomic sequencing of stool were done to identify the bacterial genes and pathways enriched in immunosuppression. Bacterial diversity was significantly decreased in sirolimus-treated rats, with 9 taxa significantly less present in both immunosuppression groups: Roseburia, Oscillospira, Mollicutes, Rothia, Micrococcaceae, Actinomycetales and Staphylococcus. Following probiotics, these changes were reversed to baseline. At the metagenomic level, the balance of metabolism was shifted towards the catabolic side with an increase of genes involved in sucrose degradation, similar to diabetes. Conversely, the control rats had greater abundance of anabolic processes and genes involved in starch degradation. Immunosuppression leads to a more catabolic microbial profile, which may influence development of diabetes after SOT. Modulation of the microbiome with probiotics may help in minimizing adverse long-term effects of immunosuppression.

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Incidence and Risk Factors for Post–Renal Transplant Diabetes Mellitus

Cited by 13 publications

References 20 publications

Assessment of Biochemical Parameters, Kidney Function, and Long-term Outcome in Renal Transplant Recipients

Assessment of Biochemical Parameters, Kidney Function, and Long-term Outcome in Renal Transplant Recipients

New-Onset Diabetes After Kidney Transplantation and Pretransplant Hypomagnesemia

Impact of Immunosuppression on the Metagenomic Composition of the Intestinal Microbiome: a Systems Biology Approach to Post-Transplant Diabetes

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