Renal impairment and diabetes mellitus after liver transplant.
BACKGROUND
One of the major concerns in liver transplant patients who survive past 1 year posttransplant is the development of chronic diseases.


OBJECTIVE
We studied two important clinical conditions that can have a chronic course-renal impairment and diabetes mellitus-among long-term liver transplant survivors.


METHODS
All adult patients transplanted and followed for at least 1 year were evaluated for clinical status, blood tests, and imaging studies. The occurrence and development of renal impairment, defined as a serum creatinine above 125 micromol/L or creatinine clearance less than 75 mL/min, or diabetes mellitus were evaluated for contributing factors.


RESULTS
The 35 evaluated patients of mean age at transplant of 50 years had a mean follow-up duration of 45 months. The incidence of posttransplant renal impairment was 22.8% at 1 year and 47.6% at 3 years. This disorder was associated with pretransplant renal impairment and with a diagnosis of diabetes. Posttransplant diabetes mellitus was observed in 48.6% with 41.1% resolving over time.


CONCLUSIONS
Posttransplant renal impairment appears to be a potential long-term problem. Although this relates to pretransplant conditions, longer follow-up is required to examine whether posttransplant factors contribute to its progression.
Sutedja
D S
DS
Singapore Liver Transplant Program, National University Hospital, Singapore. dedess@nuh.com.sg
Wai
C-T
CT
Teoh
K-F
KF
Lee
H-L
HL
DaCosta
M
M
Lee
M
M
Kaur
M
M
Lee
Y-M
YM
Lee
K-H
KH
Mak
K
K
Quak
S-H
SH
Isaac
J
J
Lim
S-G
SG
Prabhakaran
K
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology; D006801:Humans; D007674:Kidney Diseases / Q000453:epidemiology* / Q000209:etiology; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D012846:Singapore; D016896:Treatment Outcome