INTRODUCTION: New-onset diabetes after transplantation (NODAT) is an increasingly recognised metabolic complication of kidney transplantation that is associated with increased morbidity and mortality. This study aimed to determine the incidence of NODAT and identify risk factors for development of NODAT among kidney allograft recipients in a single centre. MATERIALS AND METHODS: We retrospectively reviewed all kidney allograft recipients in our centre between 1998 and 2007. NODAT were determined using criteria as per American Diabetes Association guidelines. Logistic regression analyses were performed to identify predictors of NODAT. RESULTS: Among 388 patients included in the analysis, NODAT was reported in 94 patients (24.2%) after a median follow-up time of 52.1 months. The cumulative incidence of NODAT was 15.8%, 22.8% and 24.5% at 1, 3, and 5 years following transplantation. Seven clinical factors were independent predictors of NODAT: older age, HLA B13 and B15 phenotypes, use of sirolimus, acute rejections, higher pre-transplant and post-transplant (day 1) plasma glucose levels. Patients with NODAT had poorer outcomes in both graft and patient survival. CONCLUSION: Our study demonstrates a significant risk and burden of NODAT in an Asian transplant population. Risk stratification and aggressive monitoring of blood glucose early post-transplantation is necessary to identify high-risk patients so that appropriate tailoring of immunosuppression and early institution of lifestyle modifications can be implemented.
INTRODUCTION: New-onset diabetes after transplantation (NODAT) is an increasingly recognised metabolic complication of kidney transplantation that is associated with increased morbidity and mortality. This study aimed to determine the incidence of NODAT and identify risk factors for development of NODAT among kidney allograft recipients in a single centre. MATERIALS AND METHODS: We retrospectively reviewed all kidney allograft recipients in our centre between 1998 and 2007. NODAT were determined using criteria as per American Diabetes Association guidelines. Logistic regression analyses were performed to identify predictors of NODAT. RESULTS: Among 388 patients included in the analysis, NODAT was reported in 94 patients (24.2%) after a median follow-up time of 52.1 months. The cumulative incidence of NODAT was 15.8%, 22.8% and 24.5% at 1, 3, and 5 years following transplantation. Seven clinical factors were independent predictors of NODAT: older age, HLA B13 and B15 phenotypes, use of sirolimus, acute rejections, higher pre-transplant and post-transplant (day 1) plasma glucose levels. Patients with NODAT had poorer outcomes in both graft and patient survival. CONCLUSION: Our study demonstrates a significant risk and burden of NODAT in an Asian transplant population. Risk stratification and aggressive monitoring of blood glucose early post-transplantation is necessary to identify high-risk patients so that appropriate tailoring of immunosuppression and early institution of lifestyle modifications can be implemented.
Authors: Nuvreen Phagura; Azm Hussain; Alice Culliford; James Hodson; Felicity Evison; Suzy Gallier; Richard Borrows; Hanna A Lane; David Briggs; Adnan Sharif Journal: Transplant Direct Date: 2021-07-23
Authors: Dorien M Zelle; Eva Corpeleijn; Jolijn Deinum; Ronald P Stolk; Rijk O B Gans; Gerjan Navis; Stephan J L Bakker Journal: Diabetes Care Date: 2013-02-01 Impact factor: 19.112
Authors: Gerald Klaassen; Eva Corpeleijn; Nicole P E Deetman; Gerjan J Navis; Stephan J L Bakker; Dorien M Zelle Journal: Transplant Direct Date: 2017-08-28
Authors: Jian Jin; Sun Woo Lim; Long Jin; Ji Hyun Yu; Hyun Seon Kim; Byung Ha Chung; Chul Woo Yang Journal: Korean J Intern Med Date: 2016-09-30 Impact factor: 2.884