Development of diabetes mellitus post–renal transplantation is associated with poor short-term clinical outcomes

Saleem, Taimur; Cunningham, Kiera; Hollenbeak, C.; Alfrey, Edward J.; Gabbay, Robert A.

doi:10.1016/j.transproceed.2003.10.068

Cited by 14 publications

(6 citation statements)

References 8 publications

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“…Diabetic KTR have been described as having a higher incidence of infections requiring hospitalization (e.g., septicemia, pneumonia, UTIs) . Others have reported a higher rate of infections, including life‐threatening infections, in patients who have developed diabetes post transplantation . The sharp mortality differences related to diabetes observed in our study, irrespective of CRKP or CSKP infection, warrant further study.…”

Section: Discussionsupporting

confidence: 43%

Carbapenem‐resistant Klebsiella pneumoniae infections in kidney transplant recipients: a case–control study

Simkins

Muggia

Cohen

et al. 2014

Transplant Infectious Dis

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Section: Discussionsupporting

confidence: 43%

Carbapenem‐resistant Klebsiella pneumoniae infections in kidney transplant recipients: a case–control study

Simkins

Muggia

Cohen

et al. 2014

Transplant Infectious Dis

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“…Hyperglycemia can also influence drug action including cyclosporine, which causes nephrotoxicity 22,23. In the end, PTDM contributes to cardiovascular complications and frequent inflammatory complications, which lead to a shortened lifespan 24,25. Therefore, it is important to minimize the incidence and impact of PTDM through pretransplant and posttransplant screening to identify patients with risk factors and improve the modified immunosuppressive regiments during and after transplantation coupled with glucose-lowering therapies with insulin or oral hypoglycemic agents.…”

Section: Introductionmentioning

confidence: 99%

Genetic factors in pathogenesis of diabetes mellitus after kidney transplantation

Tarnowski¹,

Słuczanowska-Głąbowska²,

Pawlik³

et al. 2017

TCRM

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Posttransplant diabetes mellitus (PTDM) is one of the major metabolic complications after transplantation of solid organs including the kidney. This type of diabetes mellitus affects allograft survival, cardiovascular complications and overall patient survival. The modifiable risk factors that contribute to PTDM include obesity, some viral infections (eg, hepatitis C virus, cytomegalovirus) and especially immunosuppressive drugs including corticosteroids, tacrolimus, cyclosporine and sirolimus. Currently, predisposing genetic factors have been considered important in PTDM development. The commonly evaluated genetic determinants include genes encoding transcription factors, cytokines, chemokines, adipokines, ionic channels, glucose transporters, cytochrome P450 enzymes and other enzymes metabolizing drugs, drug transporters. Unfortunately, the results of studies are inconclusive and differ between populations. There is a need for large genome-wide association study to identify the genetic risk factors associated with PTDM development.

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“…PTDM is now considered as a major adverse event following kidney transplantation even in children (1–8). It occurs at varying rates ranging from 4% to 40%, depending on the transplanted organ, criteria for the diagnosis of diabetes, immunosuppressive regimen and the duration of follow‐up (2–5, 9–15). However, limited information is available in pediatric kidney transplant recipients.…”

mentioning

confidence: 99%

Post-transplant glucose status in 61 pediatric renal transplant recipients: Preliminary results of five Turkish pediatric nephrology centers

Buyan

Bilge

Türkmen

et al. 2009

Pediatric Transplantation

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To assess the incidence, risk factors and outcomes of PTDM, a total of 61 non-diabetic children (24 girls, 37 boys, age: 14.5 +/- 2.1 yr) were examined after their first kidney transplantation (37.3 +/- 21.6 months) with an OGTT. At baseline, 16 (26.2%) patients had IGT, 45 (73.8%) had NGT, and no patient had PTDM. No significant difference was shown between TAC- and CSA-treated patients in terms of IGT. Higher BMI z-scores (p = 0.011), LDL-cholesterol (p < 0.05) and triglyceride levels (p < 0.01), HOMA-IR (p = 0.013) and lower HOMA-%beta (p = 0.011) were significantly associated with IGT. Fifty-four patients were re-evaluated after six months; eight patients with baseline IGT (50%) improved to NGT, three (19%) developed PTDM requiring insulin therapy, five (31%) remained with IGT, and four patients progressed from NGT to either IGT (two) or PTDM (two). These 12 progressive patients had significantly higher total cholesterol (p < 0.05), triglycerides (p < 0.05), HOMA-IR (p < 0.01) and lower HOMA-%beta (p < 0.0) than non-progressive patients at baseline. We can conclude that post-transplantation glucose abnormalities are common in Turkish pediatric kidney recipients, and higher BMI z-scores and triglyceride concentrations are the main risk factors. Considering that the progressive patients are significantly more insulin resistant at baseline, we suggest that the utility of both HOMA-IR and HOMA-%beta in predicting future risk of PTDM and/or IGT should be evaluated in children.

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Development of diabetes mellitus post–renal transplantation is associated with poor short-term clinical outcomes

Cited by 14 publications

References 8 publications

Carbapenem‐resistant Klebsiella pneumoniae infections in kidney transplant recipients: a case–control study

Carbapenem‐resistant Klebsiella pneumoniae infections in kidney transplant recipients: a case–control study

Genetic factors in pathogenesis of diabetes mellitus after kidney transplantation

Post-transplant glucose status in 61 pediatric renal transplant recipients: Preliminary results of five Turkish pediatric nephrology centers

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