Is hepatitis C a risk factor to posttransplant diabetes mellitus after renal transplantation in patients using tacrolimus?
The objective of this study was to evaluate the association between previous hepatitis C virus (HCV) infection and the occurrence of posttransplant diabetes mellitus (PTDM) among patients undergoing kidney transplants using tacrolimus (FK). From August 1999 to January 2003, 66 patients (36.4 +/- 15.5 years) underwent kidney transplantation using an immunosuppressive regimen of tacrolimus, mycophenolate mofetil, or azathioprine and steroids. Thirty-four patients (52%) received kidneys from living donors and 32 (48%) from cadaveric donors. The diagnosis of diabetes mellitus was established after two consecutive ambulatory measurements of fasting glycemia > or = 126 mg/dL. Thirty-five percent of the patients (23/66) were HCV+ and 65% (43/66) HCV-. Of the 66 patients, 33% (22) developed PTDM, 19 (82%) from the HCV+ group and only 3 (7%) from the HCV- group. Among those who developed PDTM, the diagnosis was established in the first 2 posttransplant months in most cases (68.2%). The results showed a significant association between HCV and PTDM (P < or = .0001). In this group of patients HCV infection was strongly associated with the development of PTDM. Therefore, additional care is required regarding the immunosuppressive regimen among patients with chronic HCV infection.
Finni
P E S
PE
Nephrology Service, Rio de Janeiro State University Hospital, Rio de Janeiro, RJ, Brazil. patricia.finn@hotmail.com
Souza
E R M
ER
Rioja
S
S
Ventura
S
S
Starling
P
P
Almeida
J R
JR
Ruzany
F
F
D048909:Diabetes Complications / Q000503:physiopathology* / Q000821:virology; D006526:Hepatitis C / Q000453:epidemiology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D015994:Incidence; D016030:Kidney Transplantation / Q000276:immunology*; D012189:Retrospective Studies; D012307:Risk Factors; D016559:Tacrolimus / Q000009:adverse effects*
D007166:Immunosuppressive Agents; D016559:Tacrolimus