Impact of pre-transplant dialysis modality on post-transplant diabetes mellitus after kidney transplantation

Clin Transplant. 2011 Sep-Oct;25(5):794-9. doi: 10.1111/j.1399-0012.2010.01367.x. Epub 2010 Dec 16.

Abstract

Post-transplant diabetes mellitus (PTDM) is a well-known complication in renal transplant recipients (RTRs). While a number of risk factors for PTDM have been identified, the potential impact of pre-transplant dialysis modality on subsequent development of PTDM has not yet been explored. We performed a multicenter retrospective study on 2010 consecutive RTRs who did not have a history of diabetes prior to renal transplantation. PTDM was defined as a need for anti-diabetic therapy in an RTR without a history of diabetes prior to transplantation. Analysis of the risk factors for development of PTDM was performed with respect to pre-transplant dialysis modality. A total of 137 (6.8%) patients developed PTDM; 7% in the hemodialysis group and 6.5% in the peritoneal dialysis (PD) group (p = 0.85). In the multivariate analysis, age (p < 0.001), body mass index (BMI) (p < 0.001), use of tacrolimus (p = 0.002), and rejection episodes (p < 0.001) were identified as independent risk factors for development of PTDM. Patients in the PD group were younger (p = 0.004), had lower BMI (p = 0.07), and were less likely to have a history of hepatitis C (p = 0.007) and autosomal dominant polycystic kidney disease (p = 0.07). Adjustment for these variables did not modify the results. The results of this study suggest that pre-transplant dialysis modality does not have an impact on the subsequent development of PTDM in RTRs.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Diabetes Complications / etiology*
  • Diabetes Complications / mortality
  • Diabetes Mellitus / physiopathology*
  • Female
  • Graft Rejection / drug therapy
  • Graft Rejection / etiology
  • Graft Rejection / mortality
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Kidney Failure, Chronic / complications*
  • Kidney Failure, Chronic / surgery
  • Kidney Transplantation / adverse effects*
  • Kidney Transplantation / mortality
  • Male
  • Middle Aged
  • Postoperative Complications*
  • Prognosis
  • Renal Dialysis / mortality*
  • Retrospective Studies
  • Risk Factors
  • Survival Rate

Substances

  • Immunosuppressive Agents