title: Risk of post-transplantation diabetes mellitus is greater in South Asian versus Caucasian kidney allograft recipients.
abstract: South Asians have increased risk for type 2 diabetes mellitus compared with Caucasians in the general population, but data for the development of post-transplantation diabetes mellitus (PTDM) is scarce. In this retrospective analysis, data was extracted from electronic patient records at a single centre (2004-2014). Caucasians were more likely to be male, with higher age and BMI than South Asians. Case-control matching was therefore undertaken to remove this bias, resulting in 102 recipient pairs. Median follow-up was 50 months (range 4-127 months). Matched groups had similar baseline characteristics, although South Asians compared with Caucasians received more deceased-donor kidneys (74% vs. 43%, respectively, P < 0.001) and were more likely to be CMV positive (77% vs. 43%, respectively, P < 0.001). PTDM incidence was significantly higher in South Asians versus Caucasians (35% vs. 10%, respectively, subhazard ratio 4.2 [95% CI: 2.1-8.5, P < 0.001]). Donor type had significant interaction with ethnicity, with the observed difference in PTDM rates between ethnicities most visible with receipt of deceased-donor kidneys. No significant difference was detected in allograft function, rejection episodes, adverse cardiovascular events or patient/graft survival. South Asians have increased risk of PTDM, especially recipients of deceased kidneys, and recognition of this allows appropriate patient counselling and development of targeted strategies.
authors.affiliation: Department of Nephrology and Transplantation, Queen Elizabeth Hospital, Birmingham, UK.
authors.forename: Javeria
authors.initials: J
authors.lastname: Peracha
authors.affiliation: Department of Nephrology and Transplantation, Queen Elizabeth Hospital, Birmingham, UK.|University of Birmingham, Birmingham, UK.
authors.forename: Jay
authors.initials: J
authors.lastname: Nath
authors.affiliation: Department of Nephrology and Transplantation, Queen Elizabeth Hospital, Birmingham, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Ready
authors.affiliation: University of Birmingham, Birmingham, UK.
authors.forename: Sanna
authors.initials: S
authors.lastname: Tahir
authors.affiliation: University of Birmingham, Birmingham, UK.
authors.forename: Krishan
authors.initials: K
authors.lastname: Parekh
authors.affiliation: Institute of Translational Medicine, Queen Elizabeth Hospital, Birmingham, UK.
authors.forename: James
authors.initials: J
authors.lastname: Hodson
authors.affiliation: Department of Nephrology and Transplantation, Queen Elizabeth Hospital, Birmingham, UK.
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Ferro
authors.affiliation: Department of Nephrology and Transplantation, Queen Elizabeth Hospital, Birmingham, UK.
authors.forename: Richard
authors.initials: R
authors.lastname: Borrows
authors.affiliation: Department of Nephrology and Transplantation, Queen Elizabeth Hospital, Birmingham, UK.
authors.forename: Adnan
authors.initials: A
authors.lastname: Sharif
mesh_terms: D000328:Adult; D000368:Aged; D064591:Allografts; D044466:Asian People; D015992:Body Mass Index; D048909:Diabetes Complications / Q000601:surgery; D003920:Diabetes Mellitus / Q000209:etiology*; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents; D015994:Incidence; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D051437:Renal Insufficiency / Q000208:ethnology / Q000601:surgery*; D012189:Retrospective Studies; D012306:Risk; D012307:Risk Factors; D014184:Transplantation, Homologous; D044465:White People
chemical_list: D007166:Immunosuppressive Agents
keywords: ethnicity; kidney transplant; post-transplantation diabetes; type 2 diabetes