Posttransplant diabetes mellitus in kidney allograft recipients at Shaheed Hasheminejad Hospital.
BACKGROUND
Our aim was to evaluate the frequency and risk factors of posttransplant diabetes mellitus (PTDM) at our kidney transplant center, and to compare graft and patient outcomes between the kidney recipients with and without PTDM.


METHODS
We studied 203 kidney transplant recipients with a negative history of diabetes mellitus before transplantation. We examined them for PTDM and made diagnosis on the basis of the American Diabetes Association criteria. Measurements of plasma glucose were carried out from 3 months to 24 months after transplantation. All data including recipient and donor demographics, cause of end-stage renal disease, cytomegalovirus and hepatitis C virus antibody tests, and patient and graft outcomes were assessed in relation to PTDM.


RESULTS
High fasting plasma glucose was seen in 24 (11.8%), 19 (9.4%), 16 (7.9%), and 13 (6.4%) patients at 3, 6, 12, and 24 posttransplant months, respectively. Moreover, impaired glucose tolerance was seen in 17 (8.4%), 16 (7.9%), 17 (8.4%), and 19 (9.4%) patients at the corresponding times, respectively. Accordingly, 39 patients (19.2%) were diagnosed to have PTDM. The mean age of the kidney recipients with PTDM was 46.5 +/- 12.3 years as compared to 38.6 +/- 13.4 years in nondiabetic kidney recipients (P = .02). The 5-year patient and graft survival rates were not significantly different between the kidney recipients with and without PTDM.


CONCLUSIONS
This study showed that PTDM is a common metabolic disorder in our kidney transplant patients. We recommend a less diabetogenic immunosuppressive protocol, especially for our older recipients.
Department of Kidney Transplantation, Shaheed Hasheminejad Hospital, Iran University of Medical Sciences, Tehran, Iran. ssavaj@hotmail.com.
Shokoufeh
S
Savaj
Ezatolah
E
Abdi
Hossein
H
Nejadgashti
Sasan
S
Eris
Fereidoun
F
Prooshaninia
Yosef
Y
Ataipoor
Shahrzad
S
Ossareh
Mohammad-Amin
MA
Abbasi
Hora
H
Heidari
Hamid
H
Saheb-Jamii
Kaveh
K
Ebrahimzadeh
Ahad J
AJ
Ghods
D000328:Adult; D000367:Age Factors; D016572:Cyclosporine / Q000009:adverse effects*; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology*; D004359:Drug Therapy, Combination; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000009:adverse effects / Q000031:analogs & derivatives*; D011239:Prednisolone / Q000009:adverse effects*; D011446:Prospective Studies
D007166:Immunosuppressive Agents; D016572:Cyclosporine; D011239:Prednisolone; D009173:Mycophenolic Acid