Transplant-Associated Hyperglycemia

Crutchlow, Michael F.; Bloom, Roy D.

doi:10.2215/cjn.03671106

Cited by 87 publications

(55 citation statements)

References 131 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…What should be considered is the fact that in the case of patients with diabetes prior transplant, metabolic alterations are likely to occur secondary to tacrolimus and prednisone [13].…”

Section: Discussionmentioning

confidence: 99%

The Monitoring of Immunosuppressive Therapy with Tacrolimus in Patients with Kidney Transplant, Based on the Pharmacokinetic Criteria

Mihai

Denise

Eugen

et al. 2015

Acta Medica Marisiensis

View full text Add to dashboard Cite

Background: Therapeutic drug monitoring (TDM) in patients with Chronic Kidney Disease (CKD) with kidney transplant, represents a major post transplant concern due to the characteristics of this special category of patients, particularities which can generate changes of the pharmacokinetic profile of the administered medication. Material and methods: The current study is a retrospective pharmacokinetic study, over a period of 50 months, including a group of 36 kidney transplanted patients with CKD. Tacrolimus blood concentration was determined by a validated high-performance liquid chromatography method (HPLC), at a 12 hour time interval from the last administration of the immunosuppressive medication and before the following dose (Residual concentration, Cmin(trough)). Results: During the monitoring of therapy, based on the pharmacokinetic criteria, 252 measurements of blood concentration were determined, 58 of these being outside the therapeutic window. Conclusions:The results obtained show that it is mandatory to continue to monitor closely medical therapy based on the pharmacokinetic criteria in view of improving drug administration. The other ways of monitoring therapy: the clinical and biochemical criteria should not be overlooked. In addition, the interindividual variability of patients should be considered, as well as drug interaction which can alter the pharmacokinetics of tacrolimus.

show abstract

“…What should be considered is the fact that in the case of patients with diabetes prior transplant, metabolic alterations are likely to occur secondary to tacrolimus and prednisone [13].…”

Section: Discussionmentioning

confidence: 99%

The Monitoring of Immunosuppressive Therapy with Tacrolimus in Patients with Kidney Transplant, Based on the Pharmacokinetic Criteria

Mihai

Denise

Eugen

et al. 2015

Acta Medica Marisiensis

View full text Add to dashboard Cite

show abstract

“…3 However, the incidence and prevalence of PTDM varies among studies depending on the criteria used to diagnose diabetes, the use or kinds of immunosuppressants, the characteristics of the subject, and the length of follow-up. 4 Posttransplant diabetes mellitus is an adverse effect associated with corticosteroid, cyclosporine, or tacrolimus use. Historically, immunosuppressive regimens consisting of corticosteroids and azathioprine have been associated with an incidence of PTDM as high as 46%.…”

Section: Posttransplant Diabetes Mellitusmentioning

confidence: 99%

Posttransplant Metabolic Complications in Living-Related Renal Allograft Recipients of Kashmir Valley

Shera

Yousuf²,

Mir³

et al. 2014

Exp Clin Transplant

View full text Add to dashboard Cite

Objectives: Renal transplant offers a definitive therapeutic modality for patients with end-stage renal disease; however, 50% to 70% of these patients have graft dysfunction after the transplant. Proactive prevention management of metabolic complications may reduce posttransplant morbidity and mortality in these patients. Materials and Methods: A retrospective and prospective review of 120 kidney transplant recipients during 5 years' follow-up was performed to analyze the incidence and status of the various metabolic complications after a renal transplant. Results: In our study, postrenal transplant diabetes mellitus was seen in 9 of 120 patients (7.5%). The incidence of posttransplant diabetes mellitus was 5% in tacrolimus-treated patients (n=6) compared with 2.5% in cyclosporine-treated patients (n=3). Dyslipidemia, as hypercholesterolemia and hypertriglyceridemia, was seen in 31 recipients (25.83%). Significant posttransplant hyperlipidemia was documented (P < .05). Further, it was noted that 25 patients who developed hyperlipidemia (20.83%) were taking cyclosporine-based therapy, while 6 were treated with tacrolimus-based therapy (5%; P < .05). However, most subjects with hyperlipidemia had renal graft dysfunction. Posttransplant erythrocytosis affected 9 renal transplant recipients (7.5%) with a mean (± SD) hematocrit of 41.3% ± 6.7%. A statistically significant correlation was seen between prerenal and postrenal transplant hematocrit by 12 months. Hyperparathyroidism was observed in 1 renal transplant patient (1.25%). Conclusions: On the basis of this study, we conclude that posttransplant diabetes mellitus occurred in 7.5% patients, hypercholesteremia and hypertriglyceridemia occurred in 25.83% patients, posttransplant erythrocytosis affected 7.5% patients, and hyperparathyroidism occurred in 1 renal transplant patient (1.25%). Moreover, dyslipidemia, contributed to progressive graft dysfunction.

show abstract

“…Impaired insulin secretion has been suggested to contribute to the development of CNIassociated NODAT (Crutchlow & Bloom, 2007). Experimental studies have shown that CNIs impair the function of cultured β-cells by impairing insulin gene expression (Crutchlow et al, 2007;Van Hooff et al, 2004).…”

Section: Calcineurin Inhibitorsmentioning

confidence: 99%

“…Experimental studies have shown that CNIs impair the function of cultured β-cells by impairing insulin gene expression (Crutchlow et al, 2007;Van Hooff et al, 2004). In recipients of pancreas transplants, both calcineurin inhibitors CSA and Tac have been shown to cause reversible toxicity to islet cells.…”

Section: Calcineurin Inhibitorsmentioning

confidence: 99%