Post-transplantation diabetes mellitus in patients  with kidney allotransplantation

Novikova, M.S. Novikova; Allazova, S.S. Allazova; Kotenko, O.N. Kotenko; Шилов, Е. М.; Moscow, Russia

doi:10.18565/nephrology.2018.4.20-24

Cited by 2 publications

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“…This study found that the incidence of NODAT among kidney recipients was 38.3%, which is similar to that reported from Bahrain (33.5%), 26 and India (33.85%). 27 Nevertheless, it is more often higher than in other Arab countries, [28][29][30] Japan, 31 France, 32 the United States, 5 Russia, 33 Singapore, 34 and Canada. 35 The rates in these countries ranged between 7 and 24.2%.…”

Section: Discussionmentioning

confidence: 96%

Incidence and Risk Factors for the Development of New-Onset Diabetes after Kidney Transplantation

Elamouri

2023

Journal of Diabetes and Endocrine Practice

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Objective New-onset diabetes mellitus after transplantation (NODAT), also known as posttransplant diabetes mellitus, is a common complication after kidney transplantation. It is associated with an increased risk of graft failure and death. Therefore, minimizing the risk of NODAT is a priority after kidney transplantation. This study aimed to determine the incidence of NODAT, the risk factors for its development, and the therapeutic drugs used for its management. Patients and Methods This is an observational, retrospective study on kidney recipients who were followed up in our center in 2021. After excluding known diabetic patients, second transplant patients, and those with follow-up periods less than 6 months, 308 recipients were included in the study. Demographic, clinical, and laboratory data were collected from the patient records. The patients were categorized as diabetic or nondiabetic. Results All patients' mean age was 35.9±11.6 years (standard deviation). The male-to-female ratio was 2.13:1. The overall incidence of NODAT was 38.3%. The median time to NODAT diagnosis was 6 months. Patients older than 40 were more likely to develop NODAT (61.1%; p = 0.000). The prevalence of pretransplant body mass index (BMI) more than 25 was significantly higher (67.6%) in diabetic than among nondiabetic patients (p = 0.000). NODAT patients were more likely to have had a rejection episode (65 vs. 35% in nondiabetic patients; p = 0.011). A high trough level of calcineurin inhibitors carried a significant risk of NODAT development. Tacrolimus trough level more than or equal to 10 ng/mL had an odds ratio of 57.9 (95% confidence interval [CI] 7.689–1262.2; p = 0.0007) for the development of NODAT. Likewise, a cyclosporine-A trough level more than or equal to 150 ng/mL had an odds ratio of 100.7 (95% CI: 7.31–4293.5; p = 0.0028). Conclusion NODAT incidence was high in this study. Older age, high BMI, prior rejection episode, steroid dose, and high calcineurin inhibitors trough levels were significant risk factors for developing NODAT.

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Section: Discussionmentioning

confidence: 96%

Incidence and Risk Factors for the Development of New-Onset Diabetes after Kidney Transplantation

Elamouri

2023

Journal of Diabetes and Endocrine Practice

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Interdisciplinary problem of post-transplant diabetes mellitus: literature review

Balashova

Мустафина

Глинкина

2021

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The number of transplantation and transplant survival rates increase steadily. Patients after solid organ transplantation re-ceive lifelong immunosuppressive therapy which may have adverse effects on carbohydrate and lipid metabolism. The most diabetogenic drugs are calcineurin inhibitors and corticosteroids. Posttransplant diabetes mellitus (PTDM) is hyperglycemia that meets American Diabetes Association and World Health Organization diabetes criteria for nontransplant patients and that was newly diagnosed after transplantation. PTDM may worsen both short-term and long-term transplantation outcomes so that the problem of timely diagnosis, proper treatment and prevention is critical. In early post-transplant period, transient hyperglycemia is found in the vast majority of patients; therefore, PTDM screening is carried out at least one month after transplantation. The gold standard test for PTDM diagnosis is oral glucose tolerance test. In the same time diagnostic value of hemoglobin A1C is limited. Lifestyle therapy and antidiabetic drugs are considered as possible preventive measures. Stress induced hyperglycemia management in solid organ recipients is the same with other surgical patients. Which organ was transplanted, patient characteristics and possible drug interactions with immunosuppressive therapy should be taken into account while managing PTDM. Blood pressure and lipid profile should be under control for comprehensive cardiovascu-lar risk reduction. It remains unclear which PTDM treatment and prevention strategy is the best and for better understanding interdisciplinary approach is needed.

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Post-transplantation diabetes mellitus in patients with kidney allotransplantation

Cited by 2 publications

References 0 publications

Incidence and Risk Factors for the Development of New-Onset Diabetes after Kidney Transplantation

Incidence and Risk Factors for the Development of New-Onset Diabetes after Kidney Transplantation

Interdisciplinary problem of post-transplant diabetes mellitus: literature review

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