Post-transplant glucose status in 61 pediatric renal transplant recipients: preliminary results of five Turkish pediatric nephrology centers.
To assess the incidence, risk factors and outcomes of PTDM, a total of 61 non-diabetic children (24 girls, 37 boys, age: 14.5 +/- 2.1 yr) were examined after their first kidney transplantation (37.3 +/- 21.6 months) with an OGTT. At baseline, 16 (26.2%) patients had IGT, 45 (73.8%) had NGT, and no patient had PTDM. No significant difference was shown between TAC- and CSA-treated patients in terms of IGT. Higher BMI z-scores (p = 0.011), LDL-cholesterol (p < 0.05) and triglyceride levels (p < 0.01), HOMA-IR (p = 0.013) and lower HOMA-%beta (p = 0.011) were significantly associated with IGT. Fifty-four patients were re-evaluated after six months; eight patients with baseline IGT (50%) improved to NGT, three (19%) developed PTDM requiring insulin therapy, five (31%) remained with IGT, and four patients progressed from NGT to either IGT (two) or PTDM (two). These 12 progressive patients had significantly higher total cholesterol (p < 0.05), triglycerides (p < 0.05), HOMA-IR (p < 0.01) and lower HOMA-%beta (p < 0.0) than non-progressive patients at baseline. We can conclude that post-transplantation glucose abnormalities are common in Turkish pediatric kidney recipients, and higher BMI z-scores and triglyceride concentrations are the main risk factors. Considering that the progressive patients are significantly more insulin resistant at baseline, we suggest that the utility of both HOMA-IR and HOMA-%beta in predicting future risk of PTDM and/or IGT should be evaluated in children.
Buyan
Necla
N
Pediatric Nephrology Department, Gazi University, Ankara, Turkey.
Bilge
Ilmay
I
Turkmen
Mehmet A
MA
Bayrakci
Umut
U
Emre
Sevinc
S
Fidan
Kibriya
K
Baskin
Esra
E
Gok
Faysal
F
Bas
Firdevs
F
Bideci
Aysun
A
D000293:Adolescent; D001786:Blood Glucose; D002648:Child; D003920:Diabetes Mellitus / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D007333:Insulin Resistance; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D011446:Prospective Studies
D001786:Blood Glucose; D007166:Immunosuppressive Agents