title: Impact of pre-transplant dialysis modality on post-transplant diabetes mellitus after kidney transplantation.
abstract: Post-transplant diabetes mellitus (PTDM) is a well-known complication in renal transplant recipients (RTRs). While a number of risk factors for PTDM have been identified, the potential impact of pre-transplant dialysis modality on subsequent development of PTDM has not yet been explored. We performed a multicenter retrospective study on 2010 consecutive RTRs who did not have a history of diabetes prior to renal transplantation. PTDM was defined as a need for anti-diabetic therapy in an RTR without a history of diabetes prior to transplantation. Analysis of the risk factors for development of PTDM was performed with respect to pre-transplant dialysis modality. A total of 137 (6.8%) patients developed PTDM; 7% in the hemodialysis group and 6.5% in the peritoneal dialysis (PD) group (p = 0.85). In the multivariate analysis, age (p < 0.001), body mass index (BMI) (p < 0.001), use of tacrolimus (p = 0.002), and rejection episodes (p < 0.001) were identified as independent risk factors for development of PTDM. Patients in the PD group were younger (p = 0.004), had lower BMI (p = 0.07), and were less likely to have a history of hepatitis C (p = 0.007) and autosomal dominant polycystic kidney disease (p = 0.07). Adjustment for these variables did not modify the results. The results of this study suggest that pre-transplant dialysis modality does not have an impact on the subsequent development of PTDM in RTRs.
authors.affiliation: Department of Nephrology, Dialysis, and Renal Transplantation, Saint Jacques University Hospital, Besançon, France. ccourivaud@chu-besancon.fr
authors.forename: Cécile
authors.initials: C
authors.lastname: Courivaud
authors.forename: Marc
authors.initials: M
authors.lastname: Ladrière
authors.forename: Olivier
authors.initials: O
authors.lastname: Toupance
authors.forename: Sophie
authors.initials: S
authors.lastname: Caillard
authors.forename: Bruno
authors.initials: B
authors.lastname: Hurault de Ligny
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Ryckelynck
authors.forename: Bruno
authors.initials: B
authors.lastname: Moulin
authors.forename: Philippe
authors.initials: P
authors.lastname: Rieu
authors.forename: Luc
authors.initials: L
authors.lastname: Frimat
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Chalopin
authors.forename: Sylvie
authors.initials: S
authors.lastname: Chauvé
authors.forename: Amir
authors.initials: A
authors.lastname: Kazory
authors.forename: Didier
authors.initials: D
authors.lastname: Ducloux
mesh_terms: D048909:Diabetes Complications / Q000209:etiology* / Q000401:mortality; D003920:Diabetes Mellitus / Q000503:physiopathology*; D005260:Female; D006084:Graft Rejection / Q000188:drug therapy / Q000209:etiology / Q000401:mortality; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000601:surgery; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D006435:Renal Dialysis / Q000401:mortality*; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate
chemical_list: D007166:Immunosuppressive Agents