Polycystic kidney disease as a risk factor for post-transplant diabetes mellitus.
BACKGROUND
Insulin resistance with compensatory hyperinsulinaemia has been reported in adult polycystic kidney disease (APKD) patients. Diabetes mellitus is a common complication following transplantation and previous studies have demonstrated that inadequate insulin secretion was a prerequisite for the development of post-transplant diabetes mellitus (PTDM). We conducted a retrospective study to determine whether APKD is a risk factor for PTDM.


METHODS
Twenty-six consecutive patients transplanted because of end-stage renal disease due to APKD were studied. A control patient matched for age, gender, immunosuppressive therapy and transplant year was selected for each APKD patient. PTDM was defined by fasting glycaemia exceeding 7.8 mmol/l and the need for insulin or oral antidiabetic therapy.


RESULTS
Age, renal function, immunosuppressive regimen, number of acute rejection, cumulative dose of steroids and haemodialysis duration before transplantation were similar in both groups. PTDM occured in 10 APKD patients and four controls (34.6% vs 15.3%; P < 0.005). Among diabetic patients, six APKD patients and two controls required insulin therapy (60% vs 50%; P = n.s.). Diabetic patients were significantly older (55.8 +/- 7 years vs 50.2 +/- 11 years; P < 0.05).


CONCLUSIONS
Although retrospective, this study suggests that APKD confers an increased risk of PTDM.
Ducloux
D
D
Department of Nephrology and Renal Transplantation, Hôpital Saint Jacques, Besançon, France.
Motte
G
G
Vautrin
P
P
Bresson-Vautrin
C
C
Rebibou
J M
JM
Chalopin
J M
JM
D000328:Adult; D016022:Case-Control Studies; D003920:Diabetes Mellitus / Q000209:etiology*; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000601:surgery; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D016891:Polycystic Kidney, Autosomal Dominant / Q000150:complications* / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors