title: Early hyperglycemia: a risk factor for posttransplant diabetes mellitus among renal transplant recipients.
abstract: To ascertain the frequency, epidemiology, and risk factors of posttransplant diabetes mellitus (PTDM), a retrospective analysis of all first renal transplantations, without personal history of diabetes (DM) and with a follow up >or=6 months, was performed. All patients received methylprednisolone (0.5-1 g IV) immediately prior to surgery, followed by immunosuppression including steroids, cyclosporine, and azathioprine most frequently. Early hyperglycemia was defined as values >126 mg/dL during the first week after transplantation and DM by 2 blood glucose levels of >126 mg/dL after the first month of follow-up. Included were 163 patients, namely, 57.6% males and 66% recipients of a deceased donor and 12% with a first-degree family history of DM. Mean age at transplantation was 39 years (range, 17-70 years) with a mean follow-up of 64 months. Among the 163 total subjects, some developed PTDM with frequencies of 7.5%, 13%, and 23% at 1, 5, and 10 years, respectively. Among patients with a first-degree family history of DM, 37% developed PTDM compared with 14% of those without it (odds ratio [OR] = 3.6; P < .05). Early hyperglycemia was observed in 55/92 patients, 15 of whom developed PTDM. Among patients with PTDM, the frequency of early hyperglycemia was 87% compared with 54% among those who did not develop this complication (OR = 5.4; P < .05). We confirmed a high frequency of PTDM, identifying risk factors such as a first-degree family history of DM and the development of early hyperglycemia, which should be taken into account to increase our diagnostic sensitivity and improve therapeutic individualization among renal transplant patients.
authors.affiliation: Department of Nephrology, Instituto de Medicina, Universidad Austral de Chile, Valdivia, Chile.
authors.forename: F
authors.initials: F
authors.lastname: Maldonado
authors.forename: G
authors.initials: G
authors.lastname: Tapia
authors.forename: L
authors.initials: L
authors.lastname: Ardiles
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000209:etiology / Q000235:genetics; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology / Q000209:etiology; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015994:Incidence; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000276:immunology / Q000401:mortality; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D017741:Survivors; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents; D008775:Methylprednisolone