New onset diabetes after transplantation (NODAT): an overview

Pham, Phuong‐Thu T.; Pham, Phuong-Mai T.; Pham, Son V.; Pham, Phuong-Anh T.; Pham, Phuong‐Chi T.

doi:10.2147/dmso.s19027

Cited by 204 publications

(185 citation statements)

References 71 publications

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“…21,23,[30][31][32][33][34][35][36][37][38][39][40] This HR represents statistically significant evidence of greater allograft loss in obese transplant recipients (heterogeneity, I 2 = 3%; P = .49). 45 In comparison with healthy renal transplant recipients (BMI of 18.5-24.9 kg/m 2 ), obese renal transplant recipients had an HR of developing type 2 diabetes mellitus of 1.01 (95% CI, 0.98-1.07). 22,25,31,37,41 These results indicate essentially no statistically significant difference in the risks of developing type 2 diabetes mellitus between healthy transplant recipients and obese transplant recipients (heterogeneity, 74%; P < .01).…”

Section: Allograft Lossmentioning

confidence: 97%

Untitled

2016

Exp Clin Transplant

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Objectives: The prevalence of obesity is increasing rapidly and globally, yet systemic reviews on this topic are scarce. Our meta-analysis and systemic review aimed to assess how obesity affects 5 postoperative outcomes: biopsy-proven acute rejection, patient death, allograft loss, type 2 diabetes mellitus after transplant, and delayed graft function. Materials and Methods: We evaluated peer-reviewed literature from 22 medical databases. Studies were included if they were conducted in accordance with the Meta-analysis of Observational Studies in Epidemiology criteria, only examined postoperative outcomes in adult patients, only examined the relation between recipient obesity at time of transplant and our 5 postoperative outcomes, and had a minimum score of > 5 stars on the Newcastle-Ottawa scale for nonrandomized studies. Reliable conclusions were ensured by having our studies examined against 2 internationally known scoring systems. Obesity was defined in accordance with the World Health Organization as having a body mass index of > 30 kg/m 2 . All obese recipients were compared versus "healthy" recipients (body mass index of 18.5-24.9 kg/m 2 ). Hazard ratios were calculated for biopsy-proven acute rejection, patient death, allograft loss, and type 2 diabetes mellitus after transplant. An odds ratio was calculated for delayed graft function. Results: We assessed 21 retrospective observational studies in our meta-analysis (N = 241 381 patients). In obese transplant recipients, hazard ratios were 1.51 (95% confidence interval, 1.24-1.78) for presence of biopsy-proven acute rejection, 1.19 (95% confidence interval, 1.10-1.31) for patient death, 1.54 (95% confidence interval, 1.38-1.68) for allograft loss, and 1.01 (95% confidence interval, 0.98-1.07) for development of type 2 diabetes mellitus. The odds ratio for delayed graft function was 1.81 (95% confidence interval, 1.51-2.13). Conclusions: Our meta-analysis clearly demonstrated greater risks for obese renal transplant recipients and poorer postoperative outcomes with obesity. We confidently recommend renal transplant candidates seek medically supervised weight loss before transplant.

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Section: Allograft Lossmentioning

confidence: 97%

Untitled

2016

Exp Clin Transplant

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“…Physical activity of at least 150 minutes a week is recommended as a strategy for preventing NODAT (ref. 57 ).…”

Section: Pre-transplantation Managementmentioning

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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“…Bu nedenlen NODAT'ın bildirilen prevalansı, %2 ile %53 arasında geniş değişkenlik göstermektedir (5,6). Kasiske ve ark.…”

Section: Prevalans Ve İnsidansunclassified

New-Onset Diabetes After Renal Transplantation

Bozkurt¹

2015

Turk Neph Dial Transpl

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ÖZBöbrek nakli sonrası gelişen diyabet (new-onset diabetes mellitus after transplantation, NODAT) böbrek alıcılarında yaygın olarak görülmektedir. NODAT, mikrovasküler ve kardiyovasküler hastalıklara yatkınlık kazandarak, hem greft sağkalımı azaltmakta hem de mortaliteyi artırmaktadır. Var olan ya da nakil sonrasında ortaya çıkan birçok risk faktörü ile kullanılan immünosüpresifler NODAT oluşumuyla ilişkilidir. Farklı sınıflandırma sistemleri ve tanımlamalardan dolayı böbrek nakli sonrası gelişen NODAT'ın gerçek insidansını belirlemek zordur. NODAT ve NODAT ile ilişkili faktörlerin iyi bilinmesi, yüksek riskli hastaların ayırt edilmesinde ve önleme/tedavi yaklaşımlarının belirlenmesinde klinisyenler için büyük önem taşımaktadır. NODAT riski, önleyici tedbirler alınarak ve immünosüpresif kullanımının iyi planlaması ile azaltılabilmektedir. Tanı sonrası NODAT'a yönelik özel antihiperglisemik tedavinin uygulanması, glisemik kontrol için gerekli olup nakil sonrası mortalite ve morbiditenin anlamlı ölçüde azalmasına katkı sağlamaktadır. Bu derlemede, NODAT gelişiminde rol oynayan risk faktörleri, tanı ve tedavi yaklaşımları güncel bilgiler ışığında özetlenecektir. ANAHTAR SÖZCÜKLER: Böbrek nakli, Böbrek nakli sonrası yeni başlayan diyabet (NODAT), Diabetes mellitus, İnsülin direnci ABSTRACTNew-onset diabetes mellitus after transplantation (NODAT) is common in kidney recipients, threatening health and longevity by predisposing to microvascular and cardiovascular disease and by reducing graft survival. Several risk factors, already present before or arising after transplantation, in particular the employed immunosuppressive regimens, have been related to the development of NODAT. The real incidence of NODAT after kidney transplantation is difficult to establish, because different classification systems and definitions have been employed over the years. Awareness of NODAT and of the NODATrelated factors is of paramount importance for the clinicians in order to individuate higher risk patients and arrange screening strategies. The risk of NODAT can be reduced by planning preventive measures and by tailoring immunosuppressive regimens according to the patient characteristics. Once NODAT has been diagnosed, the administration of specific antihyperglycemic therapy is mandatory to reach a tight glycemic control, which contributes to significantly reduce posttransplant mortality and morbidity. In this review, we summarize current knowledge on risk factors, diagnosis, treatment of NODAT.

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New onset diabetes after transplantation (NODAT): an overview

Cited by 204 publications

References 71 publications

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New-onset diabetes mellitus after renal transplantation

New-Onset Diabetes After Renal Transplantation

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