Post-transplant diabetes mellitus and methylprednisolone pharmacokinetics in African-American and Caucasian renal transplant recipients.
Post-transplant diabetes among renal transplant recipients is more prevalent in the African-American population. However, it is unknown if methylprednisolone (a commonly prescribed glucocorticoid in transplant patients) pharmacokinetics is altered among African-American renal allograft recipients compared to Caucasian counterparts. Therefore, the objectives of this study were to identify the occurrence of post-transplant diabetes in our clinic population and to characterize the pharmacokinetics of methylprednisolone among our African-American and Caucasian renal transplant recipients. A retrospective chart survey was done on African-American and Caucasian recipients with stable renal function and no history of diabetes pre-transplantation in order to characterize the occurrence of post-transplant diabetes in our clinical population. The survey was conducted from January 1985 to January 1992 in recipients with graft survival of at least 3 months. Post-transplant diabetes was defined as two fasting glucose serum concentrations greater than 140 mg/dl or one random serum glucose concentration greater than 200 mg/dl which was confirmed by a fasting serum glucose value greater than 140 mg/dl and a 2 hour post-prandial greater than 200 mg/dl. A 24-hour pharmacokinetic evaluation was conducted in a sub-group of African-American and Caucasian patients after intravenous administration of methylprednisolone. Over the survey period, 75 renal transplants (30 females; 45 males) were performed and 50 of these transplant recipients (24 females; 26 males) were not diabetic prior to the allograft placement. Of these 50 patients, 22 males and 17 females fulfilled the inclusion criteria established for the retrospective survey.(ABSTRACT TRUNCATED AT 250 WORDS)
Tornatore
K M
KM
Department of Pharmacy Practice and Medicine, School of Pharmacy, State University of New York at Buffalo, Erie County Medical Center, USA.
Biocevich
D M
DM
Reed
K A
KA
Tousley
K
K
Gray
V
V
Singh
J P
JP
Murray
B M
BM
Venuto
R C
RC
D000328:Adult; D044383:Black People; D001786:Blood Glucose / Q000032:analysis; D003404:Creatinine / Q000097:blood; D003920:Diabetes Mellitus / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000097:blood / Q000493:pharmacokinetics*; D006085:Graft Survival; D006801:Humans; D007328:Insulin / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000502:physiology; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage / Q000097:blood / Q000493:pharmacokinetics*; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D012189:Retrospective Studies; D012737:Sex Factors; D014184:Transplantation, Homologous; D044465:White People; D001741:Black or African American
D001786:Blood Glucose; D005938:Glucocorticoids; D007328:Insulin; D003404:Creatinine; D008775:Methylprednisolone