Posttransplant Diabetes Mellitus: Analysis of Risk Factors, Effects on Biochemical Parameters and Graft Function 5 Years after Renal Transplantation

Desai, Madhav; Ram, R; Dakshinamurty, Kaligotla Venkata

doi:10.1016/j.transproceed.2010.09.077

Cited by 17 publications

(9 citation statements)

References 20 publications

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“…The 10-year graft survival was higher in patients who were HCV-negative with NODAT (group 2) (Figure 2), with statistical significance between the 4 groups (P = .012), and this was similar to a previous study that found no difference regarding graft survival 6 but unlike several studies that reported that NODAT had been associated with worse graft outcomes. 40,41 This difference can be attributed to the fact that graft function was measured only by serum creatinine level.…”

Section: Discussionsupporting

confidence: 86%

“…The incidence ranges from 2% to 53%, reflecting wide variations in the definition of the disorder, population, and immunosuppressive regimen. 6 In our study, frequency of development of DM was greater in the HCV-positive (27%) than HCV- Abbreviations: ALT, alanine aminotransferase; DM, diabetes mellitus; HCV, hepatitis C virus *Data reported as mean ± SD or number (%). Abbreviations: DM, diabetes mellitus; HCV, hepatitis C virus *Data reported as mean ± SD or number (%).…”

Section: Discussionmentioning

confidence: 48%

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Untitled

2015

Exp Clin Transplant

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Objectives: New-onset diabetes mellitus after transplant is a common complication in renal allograft recipients. Recently, a high prevalence of diabetes mellitus has been reported in patients with chronic hepatitis C virus. The association between hepatitis C and diabetes mellitus is well demonstrated in the general population, but some controversy still exists. This work aimed to study the effect of pretransplant hepatitis C virus on the development of new-onset diabetes mellitus after transplant in Egyptian livingdonor renal allotransplant recipients. Materials and Methods: This retrospective single center study included 913 kidney transplant recipients who were transplanted at Mansoura Urology and Nephrology Center between 2000 and 2010. The patients were divided into 4 groups according to their hepatitis C virus serology and diabetic status. Results: Pretransplant dialysis duration and number of blood transfusion units were statistically significant among both viremic and nonviremic groups. With respect to induction therapy, a highly statistical significance was observed between the 4 groups regarding presence and type of adjuvant therapy (P < .001). With respect to maintenance immunosuppression, high statistically significant results were observed regarding steroid and rapamycin between the 4 groups (P < .001) with lower significance regarding mycophenolate mofetil (P = .04) but no significance regarding azathioprine, cyclosporine, or tacrolimus therapy. Incidence of new-onset diabetes mellitus after transplant was statistically higher in the viremic than nonviremic group (P < .001). Conclusions: There was a positive correlation between incidence of new-onset diabetes mellitus after transplant and positive pretransplant hepatitis C virus status.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 48%

Untitled

2015

Exp Clin Transplant

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“…New onset diabetes after renal transplantation remains an Achilles heel in the long-term patient survival in renal transplant recipients. Incidence of NODAT in this study was 26.6% compared to 16-30% in other studies [5,6]. The cumulative incidence of NODAT in this study was 8.3%, 19.1% and 25% at 3, 6 and 12 months respectively whereas the USRDS data [4] showed 9.1%, 16% and 24% at 3, 12 and 36 months respectively.…”

Section: Discussioncontrasting

confidence: 58%

New Onset Diabetes after Transplant – Risk Factors, Clinical Profile and Outcome

Sakthirajan

Dhanapriya

Dineshkumar

et al. 2018

IDCD

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Background: New onset diabetes after transplant (NODAT) remains one among the significant threats to both renal allograft and patient survival. The aim of this study was to analyse the clinical profile and risk factors for NODAT.Methods: This prospective observational study involved patients who underwent renal transplantation in our centre between 2010 and 2015.Results: During the mean follow up period of 18 ± 6 months, incidence of NODAT was 26.6% and the cumulativeincidence was highest in the first year after transplant. Recipient age, pre transplant impaired fasting glucose, Hepatitis C virus (HCV) infection, family history of diabetes, tacrolimus, post transplant hypertriglyceridemia and metabolic syndrome were found to be statistically significant risk factors for NODAT. In Cox multivariate regression analysis, age and family history of diabetes were found to be independent risk factors for NODAT. Fasting C-peptide level underlines insulin resistance as predominant mechanism for NODAT in two third of patients. There were higher incidence of urinary tract infection in the NODAT patients. NODAT was found to be an independent risk factor for fungal infection and 10 year cardiovascular risk in the renal recipients. There was no significant impact of NODAT on short term graft and patient survival.Conclusion: Age, pre-transplant fasting blood glucose, family history of diabetes, HCV infection and tacrolimus were found to be the important risk factors, with insulin resistance as the predominant mechanism for NODAT.

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“…17 Considering the adverse consequences following NODAT, it is important that the association between HBV and HCV infection and incident NODAT in KTRs is well established. However, limited studies on HBV infection and incident NODAT are available to establish a reliable association between the two; it remains contentious whether HCV infection increases the risk of NODAT, with some studies reporting a significant correlation between the two, 2,4,[18][19][20][21] and others indicating no consistent association. [22][23][24][25][26] Moreover, whether coinfection with HBV and HCV exerts a greater effect on the development of NODAT than infection with each virus individually remains unclear due to the scarcity of relevant information.…”

Section: Introductionmentioning

confidence: 99%