title: Side effects of the calcineurin inhibitor, such as new-onset diabetes after kidney transplantation.
abstract: New-onset diabetes after transplantation (NODAT) is one of the frequent complications following kidney transplantation. Patients were randomized to receive cyclosporine A- or tacrolimus-based immunosuppression. Fasting and oral glucose tolerance tests were performed, and the patients were assigned to one of the following three groups based on the results: normal, impaired fasting glucose/impaired glucose tolerance (IFG/IGT), or NODAT. NODAT developed in 14% of patients receiving cyclosporine A-based immunosuppression and in 26% of patients taking tacrolimus (p = 0.0002). Albumin levels were similar, but uric acid level (p = 0.002) and the age of the recipient (p = 0.003) were significantly different comparing the diabetic and the normal groups. Evaluation of tissue samples revealed that acute cellular rejection (ACR) and interstitial fibrosis/tubular atrophy (IF/TA) were significantly different in the NODAT group. 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: University of Szeged Department of Surgery, Faculty of Medicine Pécsi u. 6 H-6720 Szeged Hungary.
authors.forename: Bernadett
authors.initials: B
authors.lastname: Borda
authors.affiliation: University of Szeged First Department of Internal Medicine, Faculty of Medicine Szeged Hungary.
authors.forename: Cs
authors.initials: C
authors.lastname: Lengyel
authors.affiliation: University of Szeged First Department of Internal Medicine, Faculty of Medicine Szeged Hungary.
authors.forename: T
authors.initials: T
authors.lastname: Várkonyi
authors.affiliation: University of Szeged Institute of Pathology, Faculty of Medicine Szeged Hungary.
authors.forename: E
authors.initials: E
authors.lastname: Kemény
authors.affiliation: University of Szeged Department of Surgery, Faculty of Medicine Pécsi u. 6 H-6720 Szeged Hungary.
authors.forename: A
authors.initials: A
authors.lastname: Ottlakán
authors.affiliation: Semmelweis University Department of Urology, Faculty of Medicine Budapest Hungary.
authors.forename: A
authors.initials: A
authors.lastname: Kubik
authors.affiliation: University of Szeged Department for Medical Translation and Communication, Faculty of Medicine Szeged Hungary.
authors.forename: Cs
authors.initials: C
authors.lastname: Keresztes
authors.affiliation: University of Szeged Department of Surgery, Faculty of Medicine Pécsi u. 6 H-6720 Szeged Hungary.
authors.forename: Gy
authors.initials: G
authors.lastname: Lázár
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001284:Atrophy; D001706:Biopsy; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D019703:Calcineurin / Q000378:metabolism; D065095:Calcineurin Inhibitors; D016572:Cyclosporine / Q000009:adverse effects*; D003920:Diabetes Mellitus / Q000097:blood / Q000139:chemically induced* / Q000453:epidemiology / Q000378:metabolism; D005215:Fasting / Q000097:blood; D005260:Female; D005355:Fibrosis; D005951:Glucose Tolerance Test; D006084:Graft Rejection / Q000276:immunology / Q000473:pathology / Q000517:prevention & control; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D015994:Incidence; D007668:Kidney / Q000187:drug effects / Q000276:immunology / Q000473:pathology; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D016559:Tacrolimus / Q000009:adverse effects*; D013997:Time Factors
chemical_list: D001786:Blood Glucose; D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D019703:Calcineurin; D016559:Tacrolimus
keywords: calcineurin inhibitors; new-onset diabetes mellitus after kidney transplantation; protocol biopsy