Diabetes mellitus after kidney transplantation: role of the impaired fasting glucose in the outcome of kidney transplantation.
BACKGROUND
Most patients suffering from chronic renal insufficiency show impaired carbohydrate metabolism. Our goals were to analyze the accumulated incidence of impaired fasting glucose (IFG) and post-transplant diabetes mellitus (PTDM) after kidney transplantation in our hospital, to assess their impacts on the survival of the graft and of the patient, and to discover the major risk factors for the development of PTDM.


METHODS
We examined alterations in carbohydrate metabolism in 920 adult patients after they received kidney transplantation. Patients were followed for a minimum period of 5 yr.


RESULTS
One year after transplantation, 12.8% of the patients had developed PTDM, and 10.3% showed an IFG level. The IFG had a negative and statistically significant influence on graft and patient survival. Host and donor age, weight, hepatitis C virus infection, and acute rejection were found to be significant risk factors.


CONCLUSIONS
Our study found a high incidence of PTDM, as described in previous studies, but with an emphasis on a greater role played by IFG, not only in its incidence, but also as a prognostic factor for the outcome of graft and patient survival. Identifying patients at risk of developing PTDM is important in offering them early and appropriate treatment.
Mollar-Puchades
M A
MA
Department of Endocrinology, University Hospital La Fe, Valencia, Spain.
Malek-Marin
T
T
Merino-Torres
J F
JF
Ramos-Escorihuela
D
D
Sánchez-Plumed
J
J
Piñón-Sellés
F
F
D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000502:physiology*; D050260:Carbohydrate Metabolism / Q000502:physiology; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000209:etiology; D005215:Fasting / Q000097:blood*; D005500:Follow-Up Studies; D006085:Graft Survival / Q000502:physiology; D006801:Humans; D015994:Incidence; D016030:Kidney Transplantation / Q000009:adverse effects / Q000534:rehabilitation / Q000706:statistics & numerical data*; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult
D001786:Blood Glucose