Polycystic kidney disease is a risk factor for new-onset diabetes after transplantation.
BACKGROUND
Data from matched historical cohort studies suggest that autosomal-dominant polycystic kidney disease (ADPKD) may be a risk factor for new-onset diabetes after transplantation (NODAT).


METHODS
A retrospective study of 429 renal allografts transplanted from 1990 through 2004 in nondiabetic patients was performed. A multivariate analysis of risk factors for NODAT was performed with focus on ADPKD.


RESULTS
A total of 6.5% of all patients developed NODAT and a further 11% developed impaired glucose tolerance. NODAT developed in 13.4% of patients with ADPKD compared with 5.2% of non-ADPKD patients (P=0.01). There were significant univariate associations between NODAT and recipient age (P=0.001) and weight (P<0.0001). There was no association between NODAT and recipient gender, human leukocyte antigen mismatch, acute rejection, or cumulative methylprednisolone dose. In a multivariate analysis, ADPKD was a strong risk factor for the development of NODAT (odds ratio [OR]=2.41, P=0.035) after correction for recipient age, weight, gender, ethnicity, and tacrolimus use. Age (OR=1.06), weight (OR=1.04), and nonwhite race (OR=5.04) were the other significant variables.


CONCLUSIONS
We conclude that ADPKD is a significant risk factor for the development of NODAT. This may influence the follow up and management choices of these patients in the future.
Hamer
Rizwan A
RA
Sheffield Kidney Institute, Northern General Hospital, Sheffield, United Kingdom.
Chow
Chern L
CL
Ong
Albert C M
AC
McKane
William S
WS
D000328:Adult; D000704:Analysis of Variance; D001786:Blood Glucose / Q000378:metabolism; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation / Q000401:mortality / Q000502:physiology; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D007690:Polycystic Kidney Diseases / Q000150:complications*; D011183:Postoperative Complications / Q000503:physiopathology*; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D014184:Transplantation, Homologous
D001786:Blood Glucose