Background New-onset diabetes after transplant (NODAT) is one of the metabolic complications of kidney transplant surgery. The incident of NODAT varies highly, from 5% up to 53%. Some factors increase the risk for NODAT, such as age, gender, immunosuppressant drugs, among others. The progressivity of NODAT leads to increased cardiovascular risks, making the identification of risk factors crucial. Method Medical records of 56 patients who have undergone kidney transplant throughout 1998-2015 were evaluated. Data obtained from the records include age, gender, history of hypertension, dyslipidemia, the use of calcineurin inhibitors (CNI), and familial history of diabetes. Bivariate analysis with crosstabs (for nominal data) was used to analyze the data, with a threshold of p < 0.25 and followed up with multivariate analysis using logistic regression. Result The mean age of subjects was 53.85±12.92 years, with 80.4% of the subjects were male. Pre-transplant hypertension was 46.4%. The CNI used were tacrolimus in 46.4% and cyclosporine in 53.6% of patients. Around 25% of patients have a familial history of diabetes and the mean triglyceride level was 165.83±77.5 mg/dl. NODAT occurred in 18 patients and the majority of occurrence happened in the first year post-transplant. Bivariate analysis shows no significant risk factors, however clinically significant risk factors were gender (male), the CNI drug used (tacrolimus), and familial history of diabetes. Further multivariate analysis showed OR for gender (male) with OR 6.532 (0.735-58.051), age with OR 5.249 (0.658-41.853)}, and the use of tacrolimus with OR 3.217 (0.895-11.571). Conclusion In this study, the clinically significant risk factors for NODAT were male gender, age, and the use of tacrolimus. However, these risk factors did not show statistical significance. Further study with bigger sample size is needed.
Background The survival outcome of transplant patients have improved in the past three decades. The short and long term survival of grafts and patients are still being widely studied. Many factors affect the survival rate such as age, gender, diabetes mellitus, and immunosuppressive therapy. Objective The study aimed to provide patients' survival rates 1, 3, and 5 years after transplant. Methods The study used a descriptive approach to 67 kidney transplant patients undergoing outpatient treatment from 1996 to 2016. The data collected were analyzed using SPSS with the Kaplan-Meier curve to observe the survival rate. Result: The survival rate of patients in 1, 3, and 5 years were 100%, 97%, and 94% respectively. The survival rate in geriatric and non-geriatric patients in the first year post-transplantation was both 100%, the third year post-transplantation survival rate was 100% and 94.7%, and the five year post-transplantation survival rate were 100% and 89.5%. The survival rate of patients receiving tacrolimus vs cyclosporine were both 100% in the first year, 97.1% vs 97% in the third year, and 97.1% vs 90.9% in the fifth year after transplant. Conclusion The survival rate of kidney transplant patients in 1, 3, and 5 years after transplant were 100%, 97%, and 94%. Geriatric patients and patients who received tacrolimus have the tendency for a higher survival rate. Further study with a bigger sample and appropriate design is needed to determine the risk factors for kidney transplant patients' survival.
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