Early hyperglycemia after allogenic kidney transplantation.
BACKGROUND
The aim of the study was to establish the impact of early hyperglycemia on development of diabetes mellitus (DM) in patients after kidney transplantation and to evaluate possible risk factors for post-transplantation DM. We also sought to assess the impact of early hyperglycemia and DM on the renal graft function in the long term (3 year follow-up).


METHODS
1200 transplant patients from one center, were followed up for 3 years. The rate of chronic rejection, CMV infection, hypertension and dyslipidemia were analyzed. The renal allograft function was examined and pancreatic function peptide C concentration was determined.


RESULTS
Early hyperglycemia (within first week after transplantation) was detected in 76 out of 1131 patients (6.7%). In this group within three years observation posttransplantation diabetes mellitus (PTDM) was observed in 57 patients (relative risk 75%). In comparison, transplanted patients with good early glucose control had 8% risk of developing DM within the same period after transplantation. In addition early hyperglycemia predisposed to worse renal graft function and higher proteinuria. The incidence of hypertension as well as the rate of CMV infection was comparable in the DM group and in non-DM patients. PTDM patients had higher values of serum peptide C concentration (p < 0.05), additionally hyperinsulinemia was observed. The kidney allograft function assessed as serum creatinine level was significantly impaired after 3 years in PTDM group compared to non-DM patients.


CONCLUSIONS
Our date show the importance of normal glucose concentration in early period after transplantation as predictive factor for diabetes mellitus development and worsening of transplanted organs.
Wyzgal
J
J
Department of Nephrological Nursing, Medical University of Warsaw, Poland. januszwyzgal@o2.pl
Paczek
L
L
Ziolkowski
J
J
Pawlowska
M
M
Rowiński
W
W
Durlik
M
M
D000328:Adult; D003404:Creatinine / Q000097:blood; D048909:Diabetes Complications / Q000378:metabolism; D003920:Diabetes Mellitus / Q000209:etiology* / Q000378:metabolism; D050171:Dyslipidemias / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D006943:Hyperglycemia / Q000150:complications* / Q000209:etiology; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D010455:Peptides / Q000097:blood; D011379:Prognosis; D012307:Risk Factors; D014184:Transplantation, Homologous / Q000009:adverse effects / Q000401:mortality / Q000706:statistics & numerical data
D010455:Peptides; C050632:polypeptide C; D003404:Creatinine