title: Relation between pretransplant magnesemia and the risk of new onset diabetes after transplantation within the first year of kidney transplantation.
abstract: BACKGROUND
  New-onset diabetes after transplantation (NODAT) is a frequent condition associated with a poor outcome. In kidney transplantation, hypomagnesemia is a frequent posttransplant complication and has been associated with calcineurin inhibitors use. Previous studies have analyzed the relationship between posttransplant hypomagnesemia and the risk of NODAT and provided conflicting conclusions. We conducted an observational study to analyze the relationship between pretransplant magnesemia (Mg) and the risk of NODAT within the first year of kidney transplantation.
  
  
  METHODS
  A cohort study was conducted to determine the risk conferred by pretransplant magnesium level on development of NODAT within 1 year posttransplant. First time kidney transplant recipients between January 2005 and December 2010 with more than 6 months of follow-up were included. Mg was measured within the 24 hours preceding kidney transplantation. NODAT was defined according to the American Diabetes Association criteria.
  
  
  RESULTS
  Among the 154 patients analyzed, 28 (18.2%) developed NODAT at year 1. NODAT patients had lower levels of pretransplant Mg as compared with non-NODAT patients (P<0.02). When patients were divided into tertiles of Mg level, NODAT developed more frequently in patients in the lower tertile (Mg <2 mg/dL) as compared with patients in the higher tertile (Mg >2.3 mg/dL) (log rank, P<0.05). A multivariate analysis after adjustment to several variables demonstrated pretransplant Mg to be an independent risk factor of NODAT.
  
  
  CONCLUSIONS
  This study supports that a low pretransplant Mg level is an independent risk factor of NODAT in kidney transplant recipients.
authors.affiliation: 1 LUNAM Université, Angers, France. 2 Université Angers, CHU Angers, Service de Néphrologie-Dialyse-Transplantation, Angers, France. 3 Université Angers, CHU Angers, Service d'Onco-Pédiatrie, Angers, France. 4 Université Angers, CHU Angers, Département d'Anesthésie et Réanimation, Angers, France. 5 Université Angers, CHU Angers, Département de Chirurgie Vasculaire, Angers, France. 6 Université Angers, CHU Angers, Département de Pathologie Cellulaire et Tissulaire, Angers, France. 7 INSERM CIE5, Hopital Robert Debré, Paris, France. 8 Address correspondence to: Jean-François Augusto, M.D., Service de Néphrologie-Dialyse-Transplantation, CHU d'Angers, 49933 Angers Cedex 9, France.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Augusto
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Subra
authors.forename: Agnès
authors.initials: A
authors.lastname: Duveau
authors.forename: Josué
authors.initials: J
authors.lastname: Rakotonjanahary
authors.forename: Corinne
authors.initials: C
authors.lastname: Dussaussoy
authors.forename: Jean
authors.initials: J
authors.lastname: Picquet
authors.forename: Anne
authors.initials: A
authors.lastname: Croue
authors.forename: Florence
authors.initials: F
authors.lastname: Villemain
authors.forename: Céline
authors.initials: C
authors.lastname: Onno
authors.forename: Johnny
authors.initials: J
authors.lastname: Sayegh
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D065095:Calcineurin Inhibitors; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000097:blood / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000009:adverse effects*; D008274:Magnesium / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D016016:Proportional Hazards Models; D051437:Renal Insufficiency / Q000097:blood / Q000150:complications*; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents; D008274:Magnesium