Development of diabetes mellitus following kidney transplantation: a Canadian experience.
The onset of diabetes mellitus following kidney transplantation or post-transplant diabetes mellitus (PTDM) is now recognized as being an increasingly common complication that is associated with poor graft and patient survival. The incidence and clinical correlates of PTDM in a Canadian kidney transplant population has not been examined and may vary based on differences in demographics (i.e. race). Furthermore, little information exists on the association of variables such as cumulative dose of corticosteroids and trough calcineurin inhibitor levels and PTDM. We examined all recipients of a kidney transplant in our center between 1995 and 2001 and found an overall PTDM rate of 9.8%. Five clinical factors were independently associated with PTDM: older recipient age, deceased donor, hepatitis C antibody status, rejection episode and use of tacrolimus (vs. cyclosporine). Furthermore, cumulative corticosteroid dose and calcineurin inhibitor trough level were not associated with PTDM. This study demonstrates that in a Canadian kidney transplant population that there is a significant risk of PTDM following kidney transplantation, and it is therefore advisable to minimize this risk.
Gourishankar
Sita
S
Division of Nephrology and Transplantation Immunology, 11-108E Clinical Sciences Building, University of Alberta, Edmonton, Alberta, Canada. sitag@ualberta.ca
Jhangri
Gian S
GS
Tonelli
Marcello
M
Wales
Loreen H
LH
Cockfield
Sandra M
SM
D000328:Adult; D000368:Aged; D015992:Body Mass Index; D002170:Canada / Q000453:epidemiology; D003586:Cytomegalovirus Infections / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology; D006085:Graft Survival; D006650:Histocompatibility Testing; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000276:immunology / Q000401:mortality; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000145:classification*; D012086:Reoperation; D012189:Retrospective Studies; D016019:Survival Analysis; D014019:Tissue Donors
D007166:Immunosuppressive Agents