scholarly journals FC 125DIURETIC USE IS  ASSOCIATED WITH INCREASED RISK FOR POSTTRANSPLANTATION DIABETES MELLITUS IN RENAL TRANSPLANT RECIPIENTS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Sara Sokooti Oskooei ◽  
Sok Cin Tye ◽  
Rianne M. Douwes ◽  
Hiddo Lambers Heerspink ◽  
Stephan Bakker
Keyword(s):  
Diabetes Mellitus ◽  
Renal Transplant ◽  
Cox Regression ◽  
Loop Diuretics ◽  
Renal Transplant Recipients ◽  
Regression Analyses ◽  
Transplant Recipients ◽  
Prospective Longitudinal Study ◽  
Increased Risk ◽  
Prospective Longitudinal

Abstract Background and Aims Posttransplantation diabetes Mellitus (PTDM) is one of the major medical problems in renal transplant recipients (RTRs). Diuretic-induced hyperglycemia and diabetes have been described in the general population. We aimed to investigate whether diuretics also increase PTDM risk in RTRs. Method We included 486 stable outpatient RTRs (with a functioning graft ≥1 year) without diabetes from a prospective longitudinal study (the Transplantlines Food and Nutrition Study [NCT02811835]). Participants were classified as diuretic users and non-diuretic users based on their medication use recording at baseline. PTDM was defined according the American Diabetes Association’s diagnostic criteria for diabetes. Multivariable Cox proportional-hazards regression analyses were performed to assess the prospective association between diuretic use and the risk of PTDM development. Results Median time since transplantation was 5.4 (2.0-12.2) years and 168 (35%) RTRs were taking diuretics. After 5.2 (IQR, 4.0 5.9) years of follow up, 54 (11%) RTRs developed PTDM. In Kaplan-Meier (log-rank test, p<0.001) and Cox regression analyses, diuretic use was found to be associated with incident PTDM after adjustment for age, sex, fasting plasma glucose (FPG), and HbA1c (hazard ratio[HR] 3.28, 95% CI 1.84-5.83; p<0.001). The association remained independent of further adjustment for potential confounders, including lifestyle, use of other medication, kidney function, transplantation-specific parameters, BMI, lipids, and blood pressure. Exploratory analyses further indicates that, in Cox regression analyses, both thiazide (n=74) and loop diuretics (n=76) as two main types of diuretics used among RTRs appeared to be associated with the development of PTDM, independent of age, sex, FPG, and HbA1c ([HR 2.70, 95% CI 1.24-5.29; p=0.012], and [HR 5.08, 95% CI 2.49-10.34; p<0.001], respectively). Conclusion This study demonstrates that diuretics overall, associated with the risk of developing PTDM in RTRs, independent of established risk factors for PTDM development. The association was consistent for thiazide and loop diuretics.

scholarly journals Statin use is prospectively associated with new onset diabetes after transplantation in renal transplant recipients

2020 ◽  
Author(s):  
Tamas Szili-Torok ◽  
Stephan J.L. Bakker ◽  
Uwe J.F. Tietge
Keyword(s):  
Renal Transplant ◽  
Cox Regression ◽  
Rank Test ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Prospective Longitudinal Study ◽  
Onset Diabetes ◽  
Prospective Longitudinal ◽  
Statin Use ◽  
New Onset

Objective: New onset diabetes after transplantation (NODAT) is frequent and worsens graft and patient outcomes in renal transplant recipients (RTR). In the general population statins are diabetogenic. This study investigated whether statins also increase NODAT risk in RTR. <p><br></p><p>Research design and methods: From a prospective longitudinal study of 606 RTR (functioning allograft >1 year, single academic center, follow-up: median 9.6 [6.6-10.2] years) 95 patients using statins were age- and gender-matched to RTR not on statins (all diabetes-free at inclusion) .</p> <p><br></p><p>Results: NODAT incidence was 7.2% (73.3% of these on statins). In Kaplan-Meier (log rank test, p=0.017) and COX regression analyses (HR, 3,86 [1.21-12.27], P=0.022) statins prospectively associated with incident NODAT, even independent of several relevant confounders including immunosuppressive medication and biomarkers of glucose homeostasis. </p> <p><br></p><p>Conclusions: This study demonstrates that statin use is prospectively associated with the development of NODAT in RTR independent of other recognized risk factors. </p>

scholarly journals Statin use is prospectively associated with new onset diabetes after transplantation in renal transplant recipients

2020 ◽  
Author(s):  
Tamas Szili-Torok ◽  
Stephan J.L. Bakker ◽  
Uwe J.F. Tietge
Keyword(s):  
Renal Transplant ◽  
Cox Regression ◽  
Rank Test ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Prospective Longitudinal Study ◽  
Onset Diabetes ◽  
Prospective Longitudinal ◽  
Statin Use ◽  
New Onset

Objective: New onset diabetes after transplantation (NODAT) is frequent and worsens graft and patient outcomes in renal transplant recipients (RTR). In the general population statins are diabetogenic. This study investigated whether statins also increase NODAT risk in RTR. <p><br></p><p>Research design and methods: From a prospective longitudinal study of 606 RTR (functioning allograft >1 year, single academic center, follow-up: median 9.6 [6.6-10.2] years) 95 patients using statins were age- and gender-matched to RTR not on statins (all diabetes-free at inclusion) .</p> <p><br></p><p>Results: NODAT incidence was 7.2% (73.3% of these on statins). In Kaplan-Meier (log rank test, p=0.017) and COX regression analyses (HR, 3,86 [1.21-12.27], P=0.022) statins prospectively associated with incident NODAT, even independent of several relevant confounders including immunosuppressive medication and biomarkers of glucose homeostasis. </p> <p><br></p><p>Conclusions: This study demonstrates that statin use is prospectively associated with the development of NODAT in RTR independent of other recognized risk factors. </p>

scholarly journals A Prospective Longitudinal Study of BK Virus Infection in 104 Renal Transplant Recipients

2005 ◽  
Vol 5 (8) ◽  
pp. 1926-1933 ◽  
Author(s):  
C. Bressollette-Bodin ◽  
M. Coste-Burel ◽  
M. Hourmant ◽  
V. Sebille ◽  
E. Andre-Garnier ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Renal Transplant ◽  
Virus Infection ◽  
Bk Virus ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Prospective Longitudinal Study ◽  
Prospective Longitudinal

Erratum: A prospective longitudinal study of BK virus infection in 120 Czech renal transplant recipients

2011 ◽  
Vol 83 (10) ◽  
pp. 1867-1867
Author(s):  
Eva Girmanova ◽  
Irena Brabcova ◽  
Stepan Bandur ◽  
Petra Hribova ◽  
Jelena Skibova ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Renal Transplant ◽  
Virus Infection ◽  
Bk Virus ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Prospective Longitudinal Study ◽  
Prospective Longitudinal

scholarly journals The Framingham Risk Score Is Associated with Chronic Graft Failure in Renal Transplant Recipients

2021 ◽  
Vol 10 (15) ◽  
pp. 3287
Author(s):  
Josephine L. C. Anderson ◽  
Margot L. Poot ◽  
Hannah L. M. Steffen ◽  
Daan Kremer ◽  
Stephan J. L. Bakker ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Risk Score ◽  
Graft Failure ◽  
Framingham Risk Score ◽  
Receiver Operating Curve ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Prospective Longitudinal Study ◽  
Framingham Risk ◽  
Prospective Longitudinal

Predicting chronic graft failure in renal transplant recipients (RTR) is an unmet clinical need. Chronic graft failure is often accompanied by transplant vasculopathy, the formation of de novo atherosclerosis in the transplanted kidney. Therefore, we determined whether the 10-year Framingham risk score (FRS), an established atherosclerotic cardiovascular disease prediction module, is associated with chronic graft failure in RTR. In this prospective longitudinal study, 600 well-characterised RTR were followed for 10 years. The association with death-censored chronic graft failure (n = 81, 13.5%) was computed. An extended Cox model showed that each one percent increase of the FRS significantly increased the risk of chronic graft failure by 4% (HR: 1.04, p < 0.001). This association remained significant after adjustment for potential confounders, including eGFR (HR: 1.03, p = 0.014). Adding the FRS to eGFR resulted in a higher AUC in a receiver operating curve (AUC = 0.79, p < 0.001) than eGFR alone (AUC = 0.75, p < 0.001), and an improvement in the model likelihood ratio statistic (67.60 to 88.39, p < 0.001). These results suggest that a combination of the FRS and eGFR improves risk prediction. The easy to determine and widely available FRS has clinical potential to predict chronic graft failure in RTR.

scholarly journals Urinary Taurine Excretion and Risk of Late Graft Failure in Renal Transplant Recipients

Nutrients ◽  
2019 ◽  
Vol 11 (9) ◽  
pp. 2212
Author(s):  
Adrian Post ◽  
M. Yusof Said ◽  
Antonio W. Gomes-Neto ◽  
Jennifer van der Krogt ◽  
Pim de Blaauw ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Graft Failure ◽  
Cox Regression ◽  
Low Risk ◽  
Renal Transplant Recipients ◽  
Regression Analyses ◽  
Transplant Recipients ◽  
Taurine Supplementation ◽  
Underlying Mechanisms

Taurine is a sulfur containing nutrient that has been shown to protect against oxidative stress, which has been implicated in the pathophysiology leading to late graft failure after renal transplantation. We prospectively investigated whether high urinary taurine excretion, reflecting high taurine intake, is associated with low risk for development of late graft failure in renal transplant recipients (RTR). Urinary taurine excretion was measured in a longitudinal cohort of 678 stable RTR. Prospective associations were assessed using Cox regression analyses. Graft failure was defined as the start of dialysis or re-transplantation. In RTR (58% male, 53 ± 13 years old, estimated glomerular filtration rate (eGFR) 45 ± 19 mL/min/1.73 m2), urinary taurine excretion (533 (210–946) µmol/24 h) was significantly associated with serum free sulfhydryl groups (β = 0.126; P = 0.001). During median follow-up for 5.3 (4.5–6.0) years, 83 (12%) patients developed graft failure. In Cox regression analyses, urinary taurine excretion was inversely associated with graft failure (hazard ratio: 0.74 (0.67–0.82); P < 0.001). This association remained significant independent of potential confounders. High urinary taurine excretion is associated with low risk of late graft failure in RTR. Therefore, increasing taurine intake may potentially support graft survival in RTR. Further studies are warranted to determine the underlying mechanisms and the potential of taurine supplementation.

A prospective longitudinal study of BK virus infection in 120 Czech renal transplant recipients

2011 ◽  
Vol 83 (8) ◽  
pp. 1395-1400 ◽  
Author(s):  
Eva Girmanova ◽  
Irena Brabcova ◽  
Stepan Bandur ◽  
Petra Hribova ◽  
Jelena Skibova ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Renal Transplant ◽  
Virus Infection ◽  
Bk Virus ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Prospective Longitudinal Study ◽  
Prospective Longitudinal

scholarly journals Female Specific Association of Low Insulin-Like Growth Factor 1 (IGF1) Levels with Increased Risk of Premature Mortality in Renal Transplant Recipients

2020 ◽  
Vol 9 (2) ◽  
pp. 293 ◽  
Author(s):  
Frank Klont ◽  
Lyanne M. Kieneker ◽  
Antonio W. Gomes-Neto ◽  
Suzanne P. Stam ◽  
Nick H. T. ten Hacken ◽  
...  
Keyword(s):  
Growth Factor ◽  
Renal Transplant ◽  
Muscle Mass ◽  
Cox Regression ◽  
Renal Transplant Recipients ◽  
Insulin Like Growth Factor ◽  
Transplant Recipients ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Female Specific

Associations between insulin-like growth factor 1 (IGF1) and mortality have been reported to be female specific in mice and in human nonagenarians. Intervention in the growth hormone (GH)-IGF1 axis may particularly benefit patients with high risk of losing muscle mass, including renal transplant recipients (RTR). We investigated whether a potential association of circulating IGF1 with all-cause mortality in stable RTR could be female specific and mediated by variation in muscle mass. To this end, plasma IGF1 levels were measured in 277 female and 343 male RTR by mass spectrometry, and their association with mortality was assessed by Cox regression. During a median follow-up time of 5.4 years, 56 female and 77 male RTR died. In females, IGF1 was inversely associated with risk (hazard ratio (HR) per 1-unit increment in log2-transformed (doubling of) IGF1 levels, 95% confidence interval (CI)) of mortality (0.40, 0.24–0.65; p < 0.001), independent of age and the estimated Glomerular filtration rate (eGFR). In equivalent analyses, no significant association was observed for males (0.85, 0.56–1.29; p = 0.44), for which it should be noted that in males, age was negatively and strongly associated with IGF1 levels. The association for females remained materially unchanged upon adjustment for potential confounders and was furthermore found to be mediated for 39% by 24 h urinary creatinine excretion. In conclusion, low IGF1 levels associate with an increased risk of all-cause mortality in female RTR, which may link to conditions of low muscle mass that are known to be associated with poor outcomes in transplantation patients. For males, the strongly negative association of age with IGF1 levels may explain why low IGF1 levels were not found to be associated with an increased risk of all-cause mortality.

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