title: Renal resistive index as a new independent risk factor for new-onset diabetes mellitus after kidney transplantation.
abstract: Pulse pressure and urinary albumin excretion were recently identified as risk factors of new-onset diabetes after renal transplantation (NODAT), suggesting that microvascular injury may be implicated in NODAT. However, the relationship between of microvascular injury and NODAT is unknown. In the present long-term (median follow-up: 5.7years; observation period: 4908 patient-years) retrospective study in 656 renal transplant recipients, the association between baseline renal resistance index (RI, used as a marker of widespread microvascular damage) and the incidence of NODAT was assessed. The incidence of NODAT was 11.2% and 14.6% at 5 and 10years, respectively, after transplantation. RI at 3months was a risk factor for NODAT [hazard ratio (HR) per 0.1: 2.19 (1.55-3.09), P<0.0001]. RI >0.75 (vs. 0≤0.75) was a potent a predictor of NODAT [HR: 3.29 (1.91-5.67), P<0.0001], even after adjustments [HR: 3.29 (1.50-7.24), P=0.0030] on age, weight, glucose, nephropathy, and arterial pressure. Similar results were observed when RI was measured at 1month [HR per 0.1:1.74 (1.33-2.27), P<0.0001] and 12months [HR per 0.1:1.74 (1.33-2.27), P<0.0001] after transplantation. High RI early after renal transplantation is a long-term risk factor for NODAT, and could be used to refine the individual risk of NODAT.
authors.affiliation: Service de Néphrologie-Immunologie Clinique, Hôpital Bretonneau, CHRU Tours, Tours, France.
authors.forename: Prisca
authors.initials: P
authors.lastname: Mutinelli-Szymanski
authors.forename: Agnès
authors.initials: A
authors.lastname: Caille
authors.forename: François
authors.initials: F
authors.lastname: Tranquart
authors.forename: Azmi
authors.initials: A
authors.lastname: Al-Najjar
authors.forename: Matthias
authors.initials: M
authors.lastname: Büchler
authors.forename: Christelle
authors.initials: C
authors.lastname: Barbet
authors.forename: Jean-Frédéric
authors.initials: JF
authors.lastname: Marlière
authors.forename: Philippe
authors.initials: P
authors.lastname: Gatault
authors.forename: Julie
authors.initials: J
authors.lastname: Réault
authors.forename: Christopher
authors.initials: C
authors.lastname: Boin
authors.forename: Valérie
authors.initials: V
authors.lastname: Chatelet
authors.forename: Inass
authors.initials: I
authors.lastname: Laouad
authors.forename: Hubert
authors.initials: H
authors.lastname: Nivet
authors.forename: Yvon
authors.initials: Y
authors.lastname: Lebranchu
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Halimi
mesh_terms: D000328:Adult; D000419:Albuminuria / Q000150:complications / Q000652:urine; D001794:Blood Pressure; D003920:Diabetes Mellitus / Q000209:etiology*; D005500:Follow-Up Studies; D006801:Humans; D007668:Kidney / Q000098:blood supply*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors