Risk Factors Related to New-Onset Diabetes after Renal Transplantation in Patients of a High Complexity University Hospital in Colombia, 20 Years of Experience

Abstract

Introduction. New-onset diabetes after transplantation (NODAT) is associated with immunosuppression. Its complications can negatively influence patients’ quality of life, which is why it is important to study the associated risk factors and expand the possible therapies in this particular group of patients. Materials and methods. Case-control study nested in a retrospective cohort. It included patients who received kidney transplantation at the high complexity University Hospital Fundación Valle del Lili in Cali, Colombia, between 1995 and 2014. Two controls were assigned for each case, depending on the type of donor and the date of the surgery. Information was collected from clinical records and the institutional TRENAL registry. We carried out a descriptive analysis of the selected variables and identified the risk factors with conditional logistic regression. Results. 122 cases were identified to which 224 controls were assigned. The median age was 44 years (IQR: 34–55), and 54% were men. Having >50 years of age at the time of transplantation (OR: 3.18, 95% CI: 1.6−6.3, p = 0.001), body mass index >30 kg/m2 (OR: 3.6, 95% CI: 1.3−9.7, p = 0.010) and being afro-descendant (OR: 2.74, 95% CI: 1.1−6.5, p = 0.023) were identified as risk factors for the development of NODAT. Pretransplant fasting plasma glucose >100 mg/dl (OR: 2.9, 95% CI: 1.4−6.4, p = 0.005) and serum triglycerides >200 mg/dl (OR: 2.5, 95% CI: 1.4−4.4, p = 0.002) were also reported as independent risk factors. Conclusion. We ratify some risk factors for the development of this important disease, which include certain modifiable characteristics. Interventions aimed at changes in lifestyle could be established in a timely manner before transplant surgery.

Cardiovascular Risk Following Conversion to Belatacept From a Calcineurin Inhibitor in Kidney Transplant Recipients: A Randomized Clinical Trial

“…Also, triglyceride, serum ApoB, and serum ApoA1 levels did not improve ( Table 4 ), which is of interest, because all 3 of these parameters are mentioned as risk factors for developing posttransplant diabetes mellitus. 43 , 44 …”

Calculated cardiovascular risk after conversion from calcineurin inhibitor to belatacept in kidney transplant recipients: A randomized controlled trial

“…Also, triglycerides, serum ApoB, and serum ApoA1 did not improve (Table 4), which is of interest, since all three of these parameters are mentioned as risk factor for developing PTDM. 43,44 Beside trough levels, we also need to consider another bias. All patients were already treated with CNI for a median of 26 months since transplantation.…”

Weight Loss Challenges in Achieving Transplant Eligibility in Patients With Kidney Failure: A Qualitative Study

“…In patients with obesity, pre-transplant weight-loss is necessary in order to reduce the risk of surgical complications at the time of transplantation and improve the outcome of graft function after transplantation [5][6][7][8] . Patients with a BMI ranging from 30-34.9 have an improved graft survival rate compared to patients with a BMI  35 9 .…”

“… 3 , 4 In patients with obesity, pretransplant weight loss is necessary to reduce the risk of surgical complications at the time of transplant and improve the outcome of graft function after transplant. 5 , 6 , 7 , 8 Patients with a body mass index (BMI) ranging from 30-34.9 kg/m 2 have an improved graft survival rate compared with patients with a BMI ≥35 kg/m 2 . 9 Obesity has become both a driver for the increased incidence of kidney failure and a barrier to treatment of patients with kidney failure.…”