Diabetes mellitus after kidney transplantation: a French multicentre observational study.
BACKGROUND
New-onset diabetes mellitus (NODM)-a common complication of kidney transplantation-is associated with increases in graft loss, morbidity and mortality.


METHODS
This is a purely observational study of 527 patients taking a calcineurin inhibitor (CNI), based on data collected at a single routine visit 6-24 months after kidney transplantation. Diabetes was defined according to ADA/WHO guidelines.


RESULTS
The mean age of the patients was 47.2 years and 61.1% were men; 49.5% were receiving cyclosporine microemulsion (CsA-ME) and 50.5% tacrolimus (Tac). NODM developed in 7.0% after a median interval of 1.6 months. In CsA-ME-treated patients, the unadjusted cumulative risks of NODM were 5.5% and 8.4% at 1- and 2-year post-transplantation, while in Tac-treated patients, the risks were respectively 17.4% and 21%. Four independent risk factors (RFs) were identified by multivariate analysis: maximum lifetime body mass index>25 [odds ratio (OR)=5.1], pre-transplantation impaired fasting glucose (OR=4.7), hepatitis C status (OR=4.7) and Tac vs CsA-ME treatment (OR=3.0).


CONCLUSIONS
NODM is associated with certain RFs present prior to kidney transplantation, and with treatment with Tac as opposed to CsA-ME.
Kamar
Nassim
N
Service de Néphrologie, Dialyse et Transplantation, CHU Rangueil, 1 avenue Jean Poulhès, TSA 50032, 31059 Toulouse Cedex 9, France. kamar.n@chu-toulouse.fr
Mariat
Christophe
C
Delahousse
Michel
M
Dantal
Jacques
J
Al Najjar
Azmi
A
Cassuto
Elisabeth
E
Lefrançois
Nicole
N
Cointault
Olivier
O
Touchard
Guy
G
Villemain
Florence
F
Di Giambattista
Fabienne
F
Benhamou
Pierre-Yves
PY
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D065095:Calcineurin Inhibitors; D016572:Cyclosporine / Q000008:administration & dosage / Q000627:therapeutic use; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D004655:Emulsions; D005215:Fasting / Q000097:blood; D005260:Female; D005602:France / Q000453:epidemiology; D006526:Hepatitis C / Q000150:complications; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D015994:Incidence; D007674:Kidney Diseases / Q000150:complications / Q000601:surgery; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D016559:Tacrolimus / Q000009:adverse effects / Q000627:therapeutic use; D013997:Time Factors
D001786:Blood Glucose; D065095:Calcineurin Inhibitors; D004655:Emulsions; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D016559:Tacrolimus