Is basiliximab induction, a novel risk factor for new onset diabetes after transplantation for living donor renal allograft recipients?
OBJECTIVE
It was found that, by affecting populations of T lymphocytes and regulatory T cells, basiliximab also indirectly affects pancreatic β-cell function and glucose homeostasis.


METHODS
In this prospective observational study, we included all renal transplant recipients from 1 July 2007 to 31 July 2011. The overall incidence of hyperglycaemia (transient hyperglycaemia, impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and new onset diabetes after transplantation (NODAT)) was compared between patients with and without basiliximab induction.


RESULTS
Of the 439 eligible study patients, 105 patients received basiliximab induction and 334 patients did not. Overall hyperglycaemia (transient hyperglycaemia, IFG, IGT and NODAT) was detected in 102/334 (30.5%) patients without induction and 44/105 (41.9%) patients with induction (P = 0.03). Of the 102 patients with hyperglycaemia in patients without basiliximab, 46 (45.1%) patients improved, while only 10 (22.7%) of the 44 patients with basiliximab improved (P = 0.016) at the end of 3 months. Finally, NODAT was observed in 56/334 (16.7%) patients without induction and 102/334 (30.5%) patients with induction. Relative risk of NODAT with basiliximab was 2.3 (95% CI 1.4-3.9) compared to that of patients without induction. Basiliximab and hepatitis C virus infection were independent risk factors for NODAT. Risk of NODAT remained high with basiliximab despite adjusting the acute rejections episodes.


CONCLUSIONS
Basiliximab induction prevents acute rejection; however, it is associated with increased risk of NODAT.
Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
Narayan
N
Prasad
Desraj
D
Gurjer
Dharmender
D
Bhadauria
Amit
A
Gupta
Aneesh
A
Srivastava
Anupama
A
Kaul
Akhilesh
A
Jaiswal
Brijesh
B
Yadav
Subhash
S
Yadav
Raj K
RK
Sharma
D000208:Acute Disease; D000328:Adult; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D000077552:Basiliximab; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D003920:Diabetes Mellitus / Q000097:blood / Q000139:chemically induced* / Q000453:epidemiology; D005260:Female; D006084:Graft Rejection / Q000276:immunology / Q000517:prevention & control; D006526:Hepatitis C / Q000453:epidemiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D015994:Incidence; D007194:India / Q000453:epidemiology; D016030:Kidney Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011993:Recombinant Fusion Proteins / Q000009:adverse effects*; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D001786:Blood Glucose; D007166:Immunosuppressive Agents; D011993:Recombinant Fusion Proteins; D000077552:Basiliximab
basiliximab induction; new onset diabetes after transplantation; renal transplantation