Detection and treatment of post kidney transplant hyperglycemia: a Spanish multicenter cross-sectional study.
BACKGROUND
The prevalence of diabetes mellitus (DM) is greater among patients with solid organ transplants than in the general population, although the factors associated with posttransplant DM (PTDM) are unknown.


OBJECTIVE
The objective of this study was to estimate the prevalence of and assess the risk factors for PTDM.


METHODS
We included outpatients with functioning isolated solid organ allografts (kidney, liver, heart, and lung). We collected demographic and posttransplant clinical data that included DM diagnostic ADA criteria, DM treatment, DM family history, presence of hepatitis C virus (HCV), immunosuppression treatment, hypertension, and dyslipidemia.


RESULTS
A total of 2178 patients included, 1410 kidney recipients, 489 liver transplants, 207 heart transplants, and 72 lung recipients. Seventeen and four-tenths percent of the patients who did not have DM prior to transplantation, developed PTDM (median time: 79 days). A greater prevalence was observed among patients with a family history, HCV, and tacrolimus treatment (with or without steroids P < .05). By logistic regression analyses, OR for these factors were 1.51, 1.65, and 1.38, respectively. Of those patients who did not suffer PTDM, 55.2% showed basal blood glucose values under 100 mg/dL; only 68% presented with a hemoglobin Alc under 6.


CONCLUSIONS
The prevalence of PTDM among kidney recipients was higher than that in the general population. DM family history, HCV positive, and tacrolimus were risk factors associated with this entity.
Martínez-Castelao
A
A
Hospital Universitario Bellvitge, Hospitalet, Barcelona, Spain. amcastel@terra.es
Hernández
M D
MD
Pascual
J
J
Morales
J M
JM
Marcen
R
R
Errasti
P
P
Romero
R
R
Oliver
J
J
Jimeno
L
L
Garcia Martinez
J
J
Mendiluce
A
A
Garcia Cosme
P
P
Mazuecos
A
A
Danz-Guajardo
D
D
Alarcon
A
A
Marrero
D
D
D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D016027:Heart Transplantation; D006801:Humans; D006943:Hyperglycemia / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D007165:Immunosuppression Therapy / Q000379:methods; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000276:immunology; D016031:Liver Transplantation; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D011183:Postoperative Complications / Q000175:diagnosis* / Q000188:drug therapy; D015995:Prevalence; D013030:Spain / Q000453:epidemiology