Jean-François Augusto1, Jean-François Subra, Agnès Duveau, Josué Rakotonjanahary, Corinne Dussaussoy, Jean Picquet, Anne Croue, Florence Villemain, Céline Onno, Johnny Sayegh. 1. 1 LUNAM Université, Angers, France. 2 Université Angers, CHU Angers, Service de Néphrologie-Dialyse-Transplantation, Angers, France. 3 Université Angers, CHU Angers, Service d'Onco-Pédiatrie, Angers, France. 4 Université Angers, CHU Angers, Département d'Anesthésie et Réanimation, Angers, France. 5 Université Angers, CHU Angers, Département de Chirurgie Vasculaire, Angers, France. 6 Université Angers, CHU Angers, Département de Pathologie Cellulaire et Tissulaire, Angers, France. 7 INSERM CIE5, Hopital Robert Debré, Paris, France. 8 Address correspondence to: Jean-François Augusto, M.D., Service de Néphrologie-Dialyse-Transplantation, CHU d'Angers, 49933 Angers Cedex 9, France.
Abstract
BACKGROUND: New-onset diabetes after transplantation (NODAT) is a frequent condition associated with a poor outcome. In kidney transplantation, hypomagnesemia is a frequent posttransplant complication and has been associated with calcineurin inhibitors use. Previous studies have analyzed the relationship between posttransplant hypomagnesemia and the risk of NODAT and provided conflicting conclusions. We conducted an observational study to analyze the relationship between pretransplant magnesemia (Mg) and the risk of NODAT within the first year of kidney transplantation. METHODS: A cohort study was conducted to determine the risk conferred by pretransplant magnesium level on development of NODAT within 1 year posttransplant. First time kidney transplant recipients between January 2005 and December 2010 with more than 6 months of follow-up were included. Mg was measured within the 24 hours preceding kidney transplantation. NODAT was defined according to the American Diabetes Association criteria. RESULTS: Among the 154 patients analyzed, 28 (18.2%) developed NODAT at year 1. NODAT patients had lower levels of pretransplant Mg as compared with non-NODAT patients (P<0.02). When patients were divided into tertiles of Mg level, NODAT developed more frequently in patients in the lower tertile (Mg <2 mg/dL) as compared with patients in the higher tertile (Mg >2.3 mg/dL) (log rank, P<0.05). A multivariate analysis after adjustment to several variables demonstrated pretransplant Mg to be an independent risk factor of NODAT. CONCLUSION: This study supports that a low pretransplant Mg level is an independent risk factor of NODAT in kidney transplant recipients.
BACKGROUND: New-onset diabetes after transplantation (NODAT) is a frequent condition associated with a poor outcome. In kidney transplantation, hypomagnesemia is a frequent posttransplant complication and has been associated with calcineurin inhibitors use. Previous studies have analyzed the relationship between posttransplant hypomagnesemia and the risk of NODAT and provided conflicting conclusions. We conducted an observational study to analyze the relationship between pretransplant magnesemia (Mg) and the risk of NODAT within the first year of kidney transplantation. METHODS: A cohort study was conducted to determine the risk conferred by pretransplant magnesium level on development of NODAT within 1 year posttransplant. First time kidney transplant recipients between January 2005 and December 2010 with more than 6 months of follow-up were included. Mg was measured within the 24 hours preceding kidney transplantation. NODAT was defined according to the American Diabetes Association criteria. RESULTS: Among the 154 patients analyzed, 28 (18.2%) developed NODAT at year 1. NODAT patients had lower levels of pretransplant Mg as compared with non-NODAT patients (P<0.02). When patients were divided into tertiles of Mg level, NODAT developed more frequently in patients in the lower tertile (Mg <2 mg/dL) as compared with patients in the higher tertile (Mg >2.3 mg/dL) (log rank, P<0.05). A multivariate analysis after adjustment to several variables demonstrated pretransplant Mg to be an independent risk factor of NODAT. CONCLUSION: This study supports that a low pretransplant Mg level is an independent risk factor of NODAT in kidney transplant recipients.
Authors: Pedro W Baron; Sergio Infante; Regina Peters; Jerusalem Tilahun; Jill Weissman; Lauren Delgado; Arputharaj Higgins Kore; W Lawrence Beeson; Michael E de Vera Journal: Ann Transplant Date: 2017-05-23 Impact factor: 1.530
Authors: Rianne M Douwes; António W Gomes-Neto; Joëlle C Schutten; Else van den Berg; Martin H de Borst; Stefan P Berger; Daan J Touw; Eelko Hak; Hans Blokzijl; Gerjan Navis; Stephan J L Bakker Journal: J Clin Med Date: 2019-12-06 Impact factor: 4.241