Pretransplantation Oral Glucose Tolerance Test Can Prevent Posttransplant Diabetes Mellitus After Renal Transplantation: Preliminary Study

Hap, Katarzyna; Madziarska, Katarzyna; Zmonarski, Sławomir; Kamińska, Dorota; Magott-Procelewska, Maria; Banasik, Mirosław; Jędrzejak, K.; Madziarski, Marcin; Hap, Wojciech; Klinger, Marian; Mazanowska, Oktawia

doi:10.1016/j.transproceed.2018.03.125

Cited by 6 publications

(6 citation statements)

References 26 publications

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“…In high immunological risk patients’ induction therapy with thymoglobulin (high risk) and anti-CD25 antibody (moderate risk) were introduced with a combination of TAC, MMF/MPA, and CS. There was no steroid withdrawal protocol after kidney transplant recipients [23]. During the 24-month observation period we observed an increase in the incidence of overweight BMI and obesity BMI in our study group (pre-KTx was 43.5%, and 24-month post-KTx was 61.3%, P =0.036).…”

Section: Resultsmentioning

confidence: 57%

“…The study group included 62 kidney transplant recipients (24 females and 38 males) who did not differ in terms of pre-KTx BMI ( P =0.368). In our clinic, patients post-KTx were treated with 2 main immunosuppressive protocols as described previously [23]. The protocols included: 1) combination of cyclosporin A (CsA) with mycophenolate mofetil/mycophenolate sodium (MMF/MPA) and corticosteroids (CS), or more frequently 2) combination of tacrolimus (TAC) with MMF/MPA and CS.…”

Section: Resultsmentioning

confidence: 99%

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Are Females More Prone Than Males to Become Obese After Kidney Transplantation?

et al. 2019

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BackgroundBeing overweight for kidney transplant recipients can cause serious side effects. Weight gain affects two-thirds of kidney transplant recipients and has been attributed to a more liberal diet after transplantation, recovery of appetite due to lack of uremic toxicity, corticosteroid use, and inadequate lifestyle changes. The aim of this study was to assess gender-dependent profile of body mass index (BMI) changes after kidney transplantation (KTx).Material/MethodsSixty-two kidney transplant recipients (38 males and 24 females), aged 46.0±12.8 years at KTx, were observed according to weight gain after KTx. BMI was calculated before transplantation (pre-KTx) and at 6, 12, and 24 months post-KTx.ResultsDuring the 24-month observation period, we found an increase in the incidence of kidney transplant recipients being overweight or obese (pre-KTx 43.5% increase and 24-month post-Ktx 61.3% increase, P=0.036). We analyzed a number of factors that could potentially influence a 24-month BMI gain including age at KTx, gender, pre-KTx BMI, time on dialysis, pre-KTx glucose metabolism disorder, and post-KTx diabetes mellitus. For female recipients, there was a significant step-wise post-KTx increase in BMI during the 24-month observation period. The overall pre-KTx to 24-month net increase for female BMI was 2 times greater than that observed for male recipients (1.90±2.20 kg/m2 versus 0.89±1.85 kg/m2, P<0.001).ConclusionsWeight gain after KTx was observed in both sexes, but the net BMI increase was more than 2 times greater in females than in males at 24-months post-KTx. This indicated the need for diet education and strict weight control in kidney transplant recipients, especially in female patients.

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Section: Resultsmentioning

confidence: 57%

Section: Resultsmentioning

confidence: 99%

Are Females More Prone Than Males to Become Obese After Kidney Transplantation?

et al. 2019

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“…Standardized blood glucose monitoring procedures following kidney transplantation is urgently needed. Recent studies focused on the predictive value of speci c indicators for PTDM, such as HbA1c( 17), metabolic syndrome(18), preoperative or postoperative OGTT (19,20) and other traditional risk factors age (21), BMI (22), etc). Nearly all clinical indicators previously proposed were included in our study, and hyper-glucose points on day 3 were independent risk factors for PTDM.…”

Section: Discussionmentioning

confidence: 99%

Establishment and validation of a predictive model for post-transplantation diabetes mellitus based on glucose status on day 3 after kidney transplantation

Yang

Zheng

Cai

et al. 2022

Preprint

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Background and objectives: Post-transplantation diabetes mellitus (PTDM) is a common complication following kidney transplantation that significantly impacts long-term clinical outcomes. The current study aimed to develop a practical model for predicting the risk of PTDM based on glucose status on day 3 after kidney transplantation.Methods: This study enrolled 300 kidney transplant recipients between October 2018 and July 2019. All recipients were randomly assigned to either development or validation cohorts in a 2:1 ratio. Univariate logistic regression was used for predictor selection. The nomogram was created using a multivariate logistic regression model and calibrated by the receiver operating characteristic curves (ROC), the calibration curves, and the decision-curve analysis. The validation model externally validated the model.Results: The cumulative probability of developing PTDM within one-year of a kidney transplant was 11%. Univariate and multivariate logistic regression analyses identified hyperglycemia on day 3 (OR 2.02, 95% CI: 1.34-3.07, p < 0.001) and recipient age (OR 1.09, 95% CI: 1.02-1.15, p = 0.007) as independent risk factors for PTDM. The calculated potential predictive risk for PTDM was found to be in perfect agreement with the observed prevalence of PTDM. When compared to the previously used glucose statute on day 5, our model had better predictive performance. Moreover, higher risk of PTDM was associated with a lower recovery rate of graft function.Conclusion: Our study confirmed that the prediction model based on day 3 blood glucose levels can provide an early and accurate prediction of PTDM. This model will assist our clinicians in identifying and intervening in high-risk patients on time to prevent PTDM.

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“…Regarding measures (vi) and (vii), Hap et al . performed OGTTs among 80 waitlisted kidney transplant candidates and recommended a low carbohydrate diet, lifestyle modification and increased physical activity to 31 patients with dysglycaemia (with 28/31 showing attenuated glucose metabolism throughout the 12-month observational period post-transplant) [ 54 ]. These results align with several measures highlighted above showing that behavioural factors such as motivation are important to enable PTDM prevention.…”

Section: Opinion Statement 6: Emphasize Lifestyle Modification To All...mentioning

confidence: 99%

International consensus on post-transplantation diabetes mellitus

Sharif,

Chakkera,

de Vries

et al. 2024

Nephrology Dialysis Transplantation

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Post-transplantation diabetes mellitus (PTDM) remains a leading complication after solid organ transplantation. Previous international PTDM consensus meetings in 2003 and 2013 provided standardized frameworks to reduce heterogeneity in diagnosis, risk stratification and management. However, the last decade has seen significant advancements in our PTDM knowledge complemented by rapidly changing treatment algorithms for management of diabetes in the general population. In view of these developments, and to ensure reduced variation in clinical practice, a 3rd international PTDM Consensus Meeting was planned and held between 6–8 May 2022 in Vienna, Austria involving global delegates with PTDM expertise to update the previous report. This update includes opinion statements concerning optimal diagnostic tools, recognition of prediabetes (impaired fasting glucose and/or impaired glucose tolerance), new mechanistic insights, immunosuppression modification, evidence-based strategies to prevent PTDM, treatment hierarchy for incorporating novel glucose-lowering agents and suggestions for the future direction of PTDM research to address unmet needs. Due to the paucity of good quality evidence, consensus meeting participants agreed making GRADE recommendations would be flawed Although kidney-allograft centric, we suggest these opinion statements can be appraised by the transplantation community for implementation across different solid organ transplant cohorts. Acknowledging the paucity of published literature, this personal viewpoint reflects consensus expert opinion. Attaining evidence is desirable to ensure establishment of optimized care for any solid organ transplant recipient at risk of, or who develops, PTDM as we strive to improve long-term outcomes.

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Pretransplantation Oral Glucose Tolerance Test Can Prevent Posttransplant Diabetes Mellitus After Renal Transplantation: Preliminary Study

Cited by 6 publications

References 26 publications

Are Females More Prone Than Males to Become Obese After Kidney Transplantation?

Are Females More Prone Than Males to Become Obese After Kidney Transplantation?

Establishment and validation of a predictive model for post-transplantation diabetes mellitus based on glucose status on day 3 after kidney transplantation

International consensus on post-transplantation diabetes mellitus

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