Early hyperglycemia: a risk factor for posttransplant diabetes mellitus among renal transplant recipients.

To ascertain the frequency, epidemiology, and risk factors of posttransplant diabetes mellitus (PTDM), a retrospective analysis of all first renal transplantations, without personal history of diabetes (DM) and with a follow up >or=6 months, was performed. All patients received methylprednisolone (0.5-1 g IV) immediately prior to surgery, followed by immunosuppression including steroids, cyclosporine, and azathioprine most frequently. Early hyperglycemia was defined as values >126 mg/dL during the first week after transplantation and DM by 2 blood glucose levels of >126 mg/dL after the first month of follow-up. Included were 163 patients, namely, 57.6% males and 66% recipients of a deceased donor and 12% with a first-degree family history of DM. Mean age at transplantation was 39 years (range, 17-70 years) with a mean follow-up of 64 months. Among the 163 total subjects, some developed PTDM with frequencies of 7.5%, 13%, and 23% at 1, 5, and 10 years, respectively. Among patients with a first-degree family history of DM, 37% developed PTDM compared with 14% of those without it (odds ratio [OR] = 3.6; P < .05). Early hyperglycemia was observed in 55/92 patients, 15 of whom developed PTDM. Among patients with PTDM, the frequency of early hyperglycemia was 87% compared with 54% among those who did not develop this complication (OR = 5.4; P < .05). We confirmed a high frequency of PTDM, identifying risk factors such as a first-degree family history of DM and the development of early hyperglycemia, which should be taken into account to increase our diagnostic sensitivity and improve therapeutic individualization among renal transplant patients.