Prevalence and risk factors of pre-diabetes after renal transplantation: a single-centre cohort study in 200 consecutive patients

Tillmann, Frank-Peter; Quack, Ivo; Schenk, A. Katrin; Grabensee, B; Rump, Lars Christian; Hetzel, Gerd R.

doi:10.1093/ndt/gfs020

Cited by 13 publications

(14 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…To date, most publications describe single point prevalence or cumulative incidences of prediabetes [24] or PTDM [21-23] at different time points. Glucose metabolism, however, is not static.…”

Section: Introductionmentioning

confidence: 99%

Dynamics of Glucose Metabolism After Kidney Transplantation

Guthoff¹,

Wagner²,

Weichbrodt³

et al. 2017

Kidney Blood Press Res

View full text Add to dashboard Cite

Background/Aims: Posttransplantation diabetes mellitus (PTDM) impacts patient and allograft survival after kidney transplantation. Prediabetes, which is an independent risk factor for PTDM, is modifiable also in a post-transplant setting. Understanding the risks and dynamics of impaired glucose metabolism after transplantation is a key component for targeted intervention. Methods: A retrospective chart analysis of all adult non-diabetic renal allograft recipients (n=251, 2007-2014) was performed. Longitudinal follow-up included fasting plasma glucose and HbA1c, as well as data on allograft function and immunosuppression at consecutive time points (months 3-6 to >5 years post transplantation). Results: Throughout follow-up, median prevalence of prediabetes and PTDM was 53.3 [52.4-55.7]% and 15.4 [15.0-16.5]%, respectively. Continuously high fluxes between states of glucose metabolism, with individual patients’ state deteriorating or improving over time, resulted in a high number of incident patients even long after transplantation. The greatest number of patients shifted between normal glucose tolerance and prediabetes, followed by those between prediabetes and PTDM. Conclusion: Prediabetes and PTDM are highly prevalent after kidney transplantation and incidences remain relevant throughout follow-up. Patient fluxes into and out of the prediabetic state show that glucose metabolism is highly dynamic after transplantation. This provides a continuous opportunity for intervention in an aim to reduce diabetes-associated complications.

show abstract

Section: Introductionmentioning

confidence: 99%

Dynamics of Glucose Metabolism After Kidney Transplantation

Guthoff¹,

Wagner²,

Weichbrodt³

et al. 2017

Kidney Blood Press Res

View full text Add to dashboard Cite

show abstract

“…15,16 Study population This study represents a long-term follow-up investigation of a cohort of 187 renal allograft recipients with prediabetes and its respective control group. 5 Individuals in whom NODAT was diagnosed by oGTT had been excluded a priori from our current analysis. Furthermore, the maintenance immunosuppressive drug regimen in those diagnosed with prediabetes on oGTT had not been changed.…”

Section: Study Approvalmentioning

confidence: 99%

“…Of 187 patients of the initial cohort, 5 one patient was lost to follow-up, 42 patients lost their graft or died, and 3 patients were excluded due to missing laboratory data. MannWhitney U test was used to compare for intergroup differences (P < .05 was considered significant).…”

Section: Effect Of Prediabetes On Renal Graft Function and Hemoglobinmentioning

confidence: 99%

“…3,4 In KTRs, oral glucose tolerance testing (oGTT) can unmask high rates of undiagnosed prediabetes. 5 Prediabetes itself and its subclasses of impaired fasting glucose and impaired glucose tolerance are recognized risk factors for cardiovascular disease and death in the general population. [6][7][8] Emerging data suggest that prediabetes in the renal transplant setting not only predisposes patients to later advent of NODAT but also represents a major cardiovascular risk factor for graft and KTR outcomes in the early posttransplant period.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, the aim of this study was to investigate and compare the long-term graft function, graft survival, and the evolution of NODAT in deceaseddonor renal transplant recipients with prediabetes and those without prediabetes. We have reported on the prevalence of prediabetes in a cohort of 200 longterm KTRs in our outpatient transplant clinic 5 and followed this cohort for several years. Results from this observational long-term follow-up trial are presented here.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Untitled

Tillmann

Radtke²,

Rump³

et al. 2017

Exp Clin Transplant

View full text Add to dashboard Cite

Objectives: This study investigated the effect of prediabetes in long-term deceased-donor renal transplant recipients regarding graft survival, graft function, and evolution of new-onset diabetes after transplant compared with a control group of graft recipients with normal glucose tolerance test results. Materials and Methods: This was a follow-up trial of 187 deceased-donor renal transplant recipients. Based on oral glucose tolerance test results, the cohort was divided into groups A and B, comprising individuals with normal glucose metabolism (n = 130, 69.9%) and individuals with prediabetes (n = 56, 30.1%). Data are shown as means ± standard errors. Results: Both groups showed similar total transplant survival (116.8 ± 5.4 vs 114.5 ± 7.4 mo; P = .742) and transplant survival measured since oral glucose tolerance test (58.5 ± 1.4 vs 59.5 ± 1.9 mo; P = .990, Mantel-Cox P = .943). Univariate and multivariate Cox regression analyses showed no association of prediabetes with graft loss. Transplant function changes were similar between cohorts (-3 ± 1 vs -5 ± 2 mL/min/1.73 m 2 body surface area, using the Chronic Kidney Disease Epidemiology Collaboration formula; P = .538). At 5-year follow-up, recipients with prediabetes had higher hemoglobin A1c than controls (5.99% ± 0.10% vs 5.67% ± 0.04%; P = .002). Prediabetes was associated with a 4.5-fold increased hazard of new-onset diabetes after transplant (P = .021). Conclusions: Prediabetes was associated with a 4.5-fold higher hazard ratio for new-onset diabetes after transplant but not with reduced graft function or survival.

show abstract

A retrospective cohort study of preoperative lipid indices and their impact on new‐onset diabetes after liver transplantation

Liang

Xue

et al. 2020

Clinical Laboratory Analysis

View full text Add to dashboard Cite

Background The correlation between preoperative lipid profiles and new‐onset diabetes after transplantation (NODAT) remains relatively unexplored in liver transplant recipients (LTRs). Thus, we aimed to investigate the preoperative lipid profiles in Chinese LTRs and evaluate the different influences of preoperative total cholesterol, total triglycerides (TG), high‐density lipoprotein cholesterol, and low‐density lipoprotein cholesterol on the development of NODAT in both sexes. Methods A total of 767 Chinese LTRs from Zhongshan Hospital were retrospectively evaluated. NODAT was defined according to the American Diabetes Association guidelines; the relationship between each preoperative lipid index and NODAT development was analyzed separately in men and women. Results Pretransplant hypotriglyceridemia was observed in 35.72% of the total LTRs. In men, only the preoperative TG level was significantly associated with incident NODAT after adjusting for potential confounders (hazard ratio 1.37, 95% confidence interval 1.13‐1.66, P = .001). There was a nonlinear relationship between the preoperative TG level and NODAT risk. The risk of NODAT significantly increased with preoperative a TG level above 0.54 mmol/L (log‐likelihood ratio test, P = .043). In women, no significant association was observed. Conclusion Among male LTRs, a higher preoperative TG level, even at a low level within the normal range, was significantly and nonlinearly associated with an increased risk of NODAT.

show abstract

Prevalence and risk factors of pre-diabetes after renal transplantation: a single-centre cohort study in 200 consecutive patients

Cited by 13 publications

References 37 publications

Dynamics of Glucose Metabolism After Kidney Transplantation

Dynamics of Glucose Metabolism After Kidney Transplantation

Untitled

A retrospective cohort study of preoperative lipid indices and their impact on new‐onset diabetes after liver transplantation

Contact Info

Product

Resources

About