Prevalence and Risk Factors of Post-Transplantation Diabetes Mellitus in Patients after Kidney Allotransplantation in Moscow

Post-transplant diabetes mellitus (PTDM) is associated with infection, cardiovascular morbidity, and mortality. A retrospective cohort study involving patients who underwent renal transplantation in a transplantation center in Taiwan from January 2000 to December 2018 was conducted to investigate the incidence and risk factors of PTDM and long-term patient and graft survival rates. High age (45–65 vs. <45 years, adjusted odds ratio (aOR) = 2.90, 95% confidence interval (CI) = 1.64–5.13, p < 0.001), high body mass index (>27 vs. <24 kg/m2, aOR = 5.35, 95% CI = 2.75–10.42, p < 0.001), and deceased organ donor (cadaveric vs. living, aOR = 2.01, 95% CI = 1.03–3.93, p = 0.04) were the three most important risk factors for the development of PTDM. The cumulative survival rate of patients and allografts was higher in patients without PTDM than in those with PTDM (p = 0.007 and 0.041, respectively). Concurrent use of calcineurin inhibitors and mammalian target of rapamycin inhibitors (mTORis) decreased the risk of PTDM (tacrolimus vs. tacrolimus with mTORi, aOR = 0.28, 95% CI = 0.14–0.55, p < 0.001). Investigating PTDM risk factors before and modifying immunosuppressant regimens after transplantation may effectively prevent PTDM development.

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TO IDENTIFY THE RISK FACTORS FOR POST TRANSPLANTATION NEW ONSET DIABETES MELLITUS

Transplantation Journal ◽

10.1097/00007890-201007272-01335 ◽

2010 ◽

Vol 90 ◽

pp. 695

Author(s):

S. GULERIA ◽

G. Bora ◽

N. Tandon ◽

N. Gupta ◽

S. Agarwal ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Post Transplantation ◽

Onset Diabetes ◽

New Onset Diabetes Mellitus ◽

New Onset

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Post-transplantation diabetes mellitus after kidney transplantation and its related factors in Iranian patients: a retrospective single-center study

Journal of Renal Injury Prevention ◽

10.34172/jrip.2021.14 ◽

2020 ◽

Vol 10 (2) ◽

pp. e14-e14

Author(s):

Elham Ramezanzadeh ◽

Azin Tirbakhsh ◽

Ali Monfared ◽

Masoud Khosravi ◽

Mohammadkazem Lebadi ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Family History ◽

Beta Blocker ◽

Cumulative Incidence ◽

Single Center ◽

Post Transplantation ◽

Family History Of Diabetes ◽

Kidney Recipients ◽

History Of

Introduction: Post-transplantation diabetes mellitus (PTDM) is a metabolic complication following transplantation, which is associated with cardiovascular disease and leads to increased post-ttransplantation morbidity and mortality. Objectives: To identify the incidence of PTDM and its risk factors in kidney recipients at a single-center in Iran. Patients and Methods: This retrospective study was conducted on 379 kidney recipients with a negative history of diabetes mellitus who underwent transplant before January 2017. PTDM was defined according to the diagnostic criteria of the American Diabetes Association (ADA) and the World Health Organization (WHO). Data on demographic, clinical characteristics and laboratory parameters were collected. Kaplan-Mayer analysis was used to evaluate the cumulative incidence of PTDM. The association between risk factors and PTDM incidence was identified with stepwise Cox regression. Results: The cumulative incidence of PTDM during a 24-month follow-up was 30.1% (95% CI: 25.6-34.8). By univariate analysis, modifiable or non-modifiable risk factors for PTDM development included recipient age, body mass index (BMI), marital status, family history of diabetes, smoking, type of transplant, hepatitis C virus (HCV), cytomegalovirus (CMV), transplant rejection, TG, tacrolimus, cyclosporine and beta blocker. In this study, family history of diabetes, type of transplant, HCV, CMV, TG, tacrolimus, and beta blocker were predictors of development of PTDM in Cox proportional hazard models. Conclusion: The incidence of PTDM was high. Identification of risk factors determines appropriate strategies for PTDM incidence risk reduction.

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Comparison of post-transplantation diabetes mellitus incidence and risk factors between kidney and liver transplantation patients

PLoS ONE ◽

10.1371/journal.pone.0226873 ◽

2020 ◽

Vol 15 (1) ◽

pp. e0226873 ◽

Cited By ~ 2

Author(s):

Vidit N. Munshi ◽

Soroush Saghafian ◽

Curtiss B. Cook ◽

K. Tuesday Werner ◽

Harini A. Chakkera

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Liver Transplantation ◽

Post Transplantation

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Post-transplantation diabetes mellitus in patients with kidney allotransplantation

Nephrology ◽

10.18565/nephrology.2018.4.20-24 ◽

2018 ◽

Vol 4_2018 ◽

pp. 20-24

Author(s):

M.S. Novikova Novikova ◽

S.S. Allazova Allazova ◽

O.N. Kotenko Kotenko ◽

Е.М. Shilov Shilov ◽

◽

...

Keyword(s):

Diabetes Mellitus ◽

Post Transplantation ◽

Kidney Allotransplantation

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Comprehensive lifestyle modification as complementary therapy to prevent and manage post-transplant diabetes mellitus*

Postępy Higieny i Medycyny Doświadczalnej ◽

10.5604/01.3001.0014.8311 ◽

2021 ◽

Vol 75 ◽

pp. 238-245

Author(s):

Katarzyna Madziarska ◽

Katarzyna Hap ◽

Oktawia Mazanowska ◽

Edyta Sutkowska

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Kidney Transplantation ◽

Lifestyle Modification ◽

Immunosuppressive Treatment ◽

Early Period ◽

Post Transplantation ◽

Metabolic Complications ◽

Post Transplant ◽

Increased Risk

Post-transplant diabetes mellitus (PTDM) is one from the most common metabolic complications after kidney transplantation. PTDM develops in the early period after transplantation. The risk factors of PTDM are carbohydrate imbalances occurring in the patient prior to transplantation, surgery and the inclusion of immunosuppressive treatment. Kidney transplant patients tend to gain weight, which is associated with an increased risk of post-transplant diabetes, cardiovascular diseases and abnormal transplanted kidney function. Patients after kidney transplantation should be advised to adopt a lifestyle based on a proper diet, exercise, weight control and smoking cessation. The strategy to reduce the risk factors for PTDM development should start before transplantation and continue after kidney transplantation. A targeted, non-pharmacological approach to patients already during the dialysis period may have a significant impact on reducing post-transplantation diabetes. Lifestyle interventions can effectively reduce the risk of development and inhibit the progression of post-transplantation diabetes. The article describes elements of comprehensive non-pharmacological management based on available knowledge of rehabilitation, dietetics and psychology.

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