title: Long-Term Effect of Renal Transplantation and Aging on Hemoglobin A1C Levels: A Case-Control Study in 191 Non-Diabetic Deceased Donor Renal Transplant Recipients.
abstract: BACKGROUND
  Reduced renal function in patients with chronic kidney disease is linked to insulin resistance; and impairments in glucose homeostasis, as measured by HbA1c levels, are related to cardiovascular events. Recently, aging has been reported to affect HbA1c levels over time in non-diabetic individuals. The objective of this study was to investigate the association between renal function and aging in non-diabetic deceased-donor renal transplant recipients.
  
  
  METHODS
  A total of 191 patients were analyzed (mean age 50.6±12.2 years, dialysis vintage 6.5±3.1 years, 53.4% male patients). HbA1-c levels were measured on the day of transplantation and on follow-up. The mean follow-up time was 4.9±3.1 years.
  
  
  RESULTS
  Renal transplantation resulted in an increase in eGFR of 38.6±18.9 mL/min/1.73 m2 as compared to baseline levels on dialysis and the mean eGFR on follow-up was 45.5±18.9 mL/min/1.73 m2. HbA1c levels increased significantly from the day of transplantation to the last follow-up (5.3±0.4% to 5.6±0.4%, p<0.0001). Correlation analysis demonstrated non-significant associations between the change in HbA1c levels and the parameters of age and renal transplant function.
  
  
  CONCLUSIONS
  In conclusion, we observed a significant increase in HbA1c levels over a 5-year post-transplant follow-up period in non-diabetic deceased-donor renal transplant recipients. In contrast to the non-diabetic general population, the increase in HbA1c observed in this cohort was greater but not associated with aging.
authors.affiliation: Department of Nephrology, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany.
authors.forename: Frank-Peter
authors.initials: FP
authors.lastname: Tillmann
authors.affiliation: Central Institute of Clinical Chemistry and Laboratory Diagnostics, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany.
authors.forename: Derik
authors.initials: D
authors.lastname: Hermsen
authors.affiliation: Department of Nephrology, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany.
authors.forename: Katrin
authors.initials: K
authors.lastname: Hemmrich
authors.affiliation: Department of Nephrology, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Woznowski
authors.affiliation: Department of Nephrology, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany.
authors.forename: Lars Christian
authors.initials: LC
authors.lastname: Rump
authors.affiliation: Department of Nephrology, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany.
authors.forename: Ivo
authors.initials: I
authors.lastname: Quack
mesh_terms: D000328:Adult; D000375:Aging / Q000097:blood*; D002102:Cadaver; D016022:Case-Control Studies; D003404:Creatinine / Q000097:blood*; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology; D016030:Kidney Transplantation / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D013997:Time Factors; D014019:Tissue Donors; D066027:Transplant Recipients; D016896:Treatment Outcome
chemical_list: D003404:Creatinine; D006442:Glycated Hemoglobin