Jin Hyuk Paek1, Seong Sik Kang1, Woo Yeong Park1, Kyubok Jin1, Sung Bae Park1, Seungyeup Han2, Chan-Duck Kim3, Han Ro4, Sik Lee5, Cheol Woong Jung6, Jae Berm Park7, Kyu Ha Huh8, Jaeseok Yang9, Curie Ahn10. 1. Department of Internal Medicine, Keimyung University School of Medicine Daegu, Korea; Keimyung University Kidney Institute, Daegu, Korea. 2. Department of Internal Medicine, Keimyung University School of Medicine Daegu, Korea; Keimyung University Kidney Institute, Daegu, Korea. Electronic address: hansy@dsmc.or.kr. 3. Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Korea. 4. Department of Internal Medicine, Gachon University, Gil Hospital, Incheon, Korea. 5. Department of Internal Medicine, Chonbuk National University Hospital, Jeonju, Korea. 6. Department of Surgery, Korea University College of Medicine, Seoul, Korea. 7. Department of Surgery, Sungkyunkwan University, Seoul Samsung Medical Center, Seoul, Korea. 8. Department of Surgery, Yonsei University College of Medicine, Seoul, Korea. 9. Transplantation Center, Seoul National University Hospital, Seoul, Korea. 10. Transplantation Center, Seoul National University Hospital, Seoul, Korea; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Abstract
BACKGROUND: Post-transplantation diabetes mellitus (PTDM) is associated with a higher risk of mortality and graft loss. The reported incidence of PTDM after kidney transplantation (KT) varies from 10% to 74% and varies by country and ethnicity. There are few reports of nationwide cohort studies on PTDM incidence and related factors in Korea. The purpose of this study was to evaluate incidence of PTDM and related factors within 1 year after KT in Korea. METHODS: The KoreaN cohort study for Outcome in patients With Kidney Transplantation (KNOW-KT) enrolled 1080 recipients from July 2012 to August 2016. This study included 723 recipients, excluding 273 patients with pretransplant DM and 84 patients who were lost from follow-up within 1 year after KT. RESULTS: Among 723 recipients, 85 (11.8%) recipients were diagnosed and treated with PTDM. Recipient age, HLA mismatches, hemoglobin A1c (HbA1c), waist-hip ratio (WHR), and use of prednisolone were significantly higher in PTDM group than the nondiabetic group. In the multivariable logistic regression analysis, independent risk factors for PTDM were older recipient age, higher WHR, and HbA1c before KT. CONCLUSION: The incidence of PTDM was 11.8% in a nationwide Korean cohort study. The factors related to the development of PTDM within 1 year after KT were older recipient age and higher WHR, and HbA1c levels before KT. In recipients with high WHR, it is important to control pretransplant abdominal obesity to prevent PTDM after KT.
BACKGROUND: Post-transplantation diabetes mellitus (PTDM) is associated with a higher risk of mortality and graft loss. The reported incidence of PTDM after kidney transplantation (KT) varies from 10% to 74% and varies by country and ethnicity. There are few reports of nationwide cohort studies on PTDM incidence and related factors in Korea. The purpose of this study was to evaluate incidence of PTDM and related factors within 1 year after KT in Korea. METHODS: The KoreaN cohort study for Outcome in patients With Kidney Transplantation (KNOW-KT) enrolled 1080 recipients from July 2012 to August 2016. This study included 723 recipients, excluding 273 patients with pretransplant DM and 84 patients who were lost from follow-up within 1 year after KT. RESULTS: Among 723 recipients, 85 (11.8%) recipients were diagnosed and treated with PTDM. Recipient age, HLA mismatches, hemoglobin A1c (HbA1c), waist-hip ratio (WHR), and use of prednisolone were significantly higher in PTDM group than the nondiabetic group. In the multivariable logistic regression analysis, independent risk factors for PTDM were older recipient age, higher WHR, and HbA1c before KT. CONCLUSION: The incidence of PTDM was 11.8% in a nationwide Korean cohort study. The factors related to the development of PTDM within 1 year after KT were older recipient age and higher WHR, and HbA1c levels before KT. In recipients with high WHR, it is important to control pretransplant abdominal obesity to prevent PTDM after KT.