Impact of Post-Transplant Diabetes Mellitus on Survival and Cardiovascular Events in Kidney Transplant Recipients

Abstract

Background: Post-transplant diabetes mellitus (PTDM) is a risk factor for poor outcomes after kidney transplantation (KT). However, the outcomes of KT have improved recently. Therefore, we investigated whether PTDM is still a risk factor for mortality, major atherosclerotic cardiovascular events (MACEs), and graft failure in KT recipients. Methods: We studied a retrospective cohort of KT recipients (between 1994 and 2017) at a single tertiary center, and compared the rates of death, MACEs, overall graft failure, and death-censored graft failure after KT between patients with and without PTDM using Kaplan-Meier analysis and a Cox proportional hazard model. Results: Of 571 KT recipients, 153 (26.8%) were diagnosed with PTDM. The mean follow-up duration was 9.6 years. In the Kaplan-Meier analysis, the PTDM group did not have a significantly increased risk of death or four-point MACE compared with the non-diabetes mellitus group (log-rank test, P = 0.957 and P = 0.079, respectively). Multivariate Cox proportional hazard models showed that PTDM did not have a negative impact on death or four-point MACE (P= 0.137 and P= 0.181, respectively). In addition, PTDM was not significantly associated with overall or death-censored graft failure. However, patients with a long duration of PTDM had a higher incidence of four-point MACE. Conclusion: Patient survival and MACEs were comparable between groups with and without PTDM. However, PTDM patients with long duration diabetes were at higher risk of cardiovascular disease.

Effect of post-transplant diabetes mellitus on cardiovascular events and mortality: a single‐center retrospective cohort study

“…We also found that patients with PTDM had comparable survival spans to those in the NoDM group, based on our study with one of the most extended follow-up periods. This conclusion aligns with Jeon et al's 27-year observational cohort study [15].…”

“…The incidence of PTDM varies greatly in studies worldwide, ranging between 10-32% [3,4,[7][8][9][10][11][12][13][14][15]. This wide range of incidence might be due to differences in the criteria used to de ne PTDM and the length of follow-up periods and study population.…”

“…Gonzalez-Posada et al showed that the number of patients with PTDM grew from 1990 to 1998, paralleling the rise in patients receiving kidney transplantation and tacrolimus treatment [13]. However, Jeon et al reported that the incidence of PTDM remained nearly the same over the past 27 years [15].…”

Safety and efficacy of semaglutide in post kidney transplant patients with type 2 diabetes or Post-Transplant diabetes

“…Some studies have suggested that deceased kidney transplantation is associated with a higher risk of diabetes development [22] . On the contrary, other studies have reported no association between transplanted kidney type and PTDM development [23] .…”