[Problems and management in kidney transplant recipients with impaired glucose metabolism].
Fourty two (12%: Group-I) out of 358 kidney transplant (Tx) recipients showed impaired glucose tolerance in pre-Tx O-GTT and the other 49 (14%: Group-II) showed that only after Tx. Insulin therapy was more frequently required and earlier started after Tx in Group-I than in Group-II, and total dosages of steroids before the initiation of insulin therapy were also smaller in Group-I. These trends were more markedly observed in the patients treated with ciclosporin (CsA) than in those with the conventional therapy. Poor graft survival rate of Group-I in long-term follow-up (> 5 years) was demonstrated. Thus, pre-Tx impaired glucose tolerance and the subsequent immunosuppressants, especially steroids and CsA, were the key factors for deteriorating glucose metabolism after Tx, and meticulous controls of drug doses and glucose levels are needed in diabetic patients, since diabetes could change the fate of kidney grafts.
Mitsuo
M
M
Second Department of Surgery, Kyoto Prefectural University of Medicine, Japan.
Nakai
I
I
Nakaji
K
K
Arakawa
K
K
Yasumura
T
T
Omori
Y
Y
Oka
T
T
D001379:Azathioprine / Q000009:adverse effects; D016572:Cyclosporine / Q000009:adverse effects; D003920:Diabetes Mellitus / Q000188:drug therapy / Q000209:etiology; D005951:Glucose Tolerance Test; D006085:Graft Survival; D006801:Humans; D007328:Insulin / Q000627:therapeutic use*; D007676:Kidney Failure, Chronic / Q000150:complications / Q000601:surgery*; D016030:Kidney Transplantation; D011379:Prognosis
D007328:Insulin; D016572:Cyclosporine; D001379:Azathioprine