title: Early histopathological changes in new-onset diabetes after kidney transplantation.
abstract: BACKGROUND
  New-onset diabetes after transplantation (NODAT) is one of the most common complications after kidney transplantation.
  
  
  METHODS
  Patients were randomly assigned to receive cyclosporine A-based or tacrolimus-based immunosuppression. Fasting and oral glucose tolerance tests were performed, and the patients were assigned to one of the following 3 groups, on the basis of the results: normal, impaired fasting glucose/impaired glucose tolerance, or NODAT. NODAT developed in 14% of patients receiving cyclosporine A-based immunosuppression and in 26% of patients taking tacrolimus (P = .0002).
  
  
  RESULTS
  Albumin levels were similar, but uric acid level (P = .002) and the age of the recipient (P = .003) were significantly different between the diabetic and the normal groups. Evaluation of tissue samples revealed that acute cellular rejection and interstitial fibrosis/tubular atrophy were significantly different in the NODAT group. Changes in the Banff score provided significant difference regarding tubulitis and interstitial inflammation (P = .05).
  
  
  CONCLUSIONS
  The pathological effect of new-onset diabetes after kidney transplantation can be detected in the morphology of the renal allograft earlier, before the development of any sign of functional impairment.
authors.affiliation: Department of Surgery, Faculty of Medicine, University of Szeged, Szeged, Hungary. Electronic address: borda.bernadett@med.u-szeged.hu.
authors.forename: B
authors.initials: B
authors.lastname: Borda
authors.affiliation: Department of Surgery, Faculty of Medicine, University of Szeged, Szeged, Hungary.
authors.forename: Y
authors.initials: Y
authors.lastname: Munir Ibrahim
authors.affiliation: First Department of Internal Medicine, Faculty of Medicine, University of Szeged, Szeged, Hungary.
authors.forename: C
authors.initials: C
authors.lastname: Lengyel
authors.affiliation: First Department of Internal Medicine, Faculty of Medicine, University of Szeged, Szeged, Hungary.
authors.forename: T
authors.initials: T
authors.lastname: Várkonyi
authors.affiliation: Department of Urology, Faculty of Medicine, Semmelweis University, Budapest, Hungary.
authors.forename: A
authors.initials: A
authors.lastname: Kubik
authors.affiliation: Department for Medical Translation and Communication, Faculty of Medicine, University of Szeged, Szeged, Hungary.
authors.forename: C
authors.initials: C
authors.lastname: Keresztes
authors.affiliation: Department of Surgery, Faculty of Medicine, University of Szeged, Szeged, Hungary.
authors.forename: G
authors.initials: G
authors.lastname: Lázár
mesh_terms: D000328:Adult; D001706:Biopsy; D003920:Diabetes Mellitus / Q000209:etiology / Q000473:pathology*; D042241:Early Diagnosis; D005260:Female; D006084:Graft Rejection / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D016559:Tacrolimus / Q000627:therapeutic use; D014184:Transplantation, Homologous / Q000009:adverse effects
chemical_list: D007166:Immunosuppressive Agents; D016559:Tacrolimus