Impaired glucose homeostasis in renal transplant recipients receiving basiliximab.
BACKGROUND
The pathogenesis of new onset diabetes after transplantation (NODAT) is multifactorial. Suppression of regulatory T lymphocytes may have a negative impact on pancreatic beta-cells. Induction with basiliximab affects regulatory T-cell function and may therefore, theoretically, also affect glucose homeostasis in renal transplant recipients.


METHODS
All kidney recipients > or =50 years of age without diabetes mellitus transplanted from 1 January 2005 to 31 December 2007 were included in a single-centre retrospective study. Immunosuppression consisted of steroids, mycophenolate mofetil and cyclosporine. Basiliximab was introduced as induction therapy 1 January 2007. An oral glucose tolerance test (OGTT) was performed in all patients 10 weeks post-transplant.


RESULTS
A total of 264 patients were recruited. One hundred and thirty-four patients received basiliximab. In the basiliximab group, 51.5% developed NODAT, impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) versus 36.9% in the group without induction therapy (P = 0.017). In recipients with normal OGTT, the mean fasting glucose at 10 weeks was 5.18 mmol/l (SD: 0.54) in the basiliximab group (n = 65) and 4.84 mmol/l (SD: 0.64) in the no induction group (n = 82) (P = 0.001).


CONCLUSIONS
Use of basiliximab as induction therapy may be associated with impaired glucose homeostasis after kidney transplantation.
Aasebø
Willy
W
Section of Nephrology, Rikshospitalet University Hospital, Oslo University Hospital, 0027 Oslo, Norway. willy.aaseboe@rikshospitalet.no
Midtvedt
Karsten
K
Valderhaug
Tone Gretland
TG
Leivestad
Torbjørn
T
Hartmann
Anders
A
Reisaeter
Anna Varberg
AV
Jenssen
Trond
T
Holdaas
Hallvard
H
D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D000077552:Basiliximab; D001786:Blood Glucose / Q000378:metabolism; D005260:Female; D005947:Glucose / Q000378:metabolism*; D018149:Glucose Intolerance; D005951:Glucose Tolerance Test; D006085:Graft Survival / Q000187:drug effects; D006706:Homeostasis / Q000187:drug effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011993:Recombinant Fusion Proteins / Q000009:adverse effects*; D012189:Retrospective Studies; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D001786:Blood Glucose; D007166:Immunosuppressive Agents; D011993:Recombinant Fusion Proteins; D000077552:Basiliximab; D005947:Glucose