title: New-Onset Diabetes After Kidney Transplantation and Pretransplant Hypomagnesemia.
abstract: OBJECTIVE
  Hypomagnesemia is a frequent finding in kidney transplant patients and plays a causal role in insulin resistance and diabetes. The aim of this study was to investigate whether the pretransplant magnesium (Mg) level is a risk factor for the development of new-onset diabetes after kidney transplantation (NODAT) and the presence of relationship between pretransplant hypomagnesemia and the development period of NODAT.
  
  
  METHODS
  Four hundred and nineteen nondiabetic renal transplant recipients were evaluated retrospectively. The patients were divided into NODAT and non-NODAT groups. The time of diagnosis of patients with NODAT was divided into 0 to 3, 3 to 6, 6 to 12 months, and after 12 months. Patients' characteristics and pretransplant Mg levels in NODAT were compared with non-NODAT, and it was investigated whether pretransplant hypomagnesemia was a risk factor for the development of NODAT.
  
  
  RESULTS
  Totally 70 (16.6%) patients (36 female [F], mean age 51.7 ± 8.2 years) were diagnosed with NODAT. Three hundred and forty-nine patients (115 F, mean age 43.2 ± 12.5 years) did not have NODAT. Pretransplant mean Mg level was 1.97 ± 0.40 mg/dL in patients with NODAT, while it was 2.5 ± 0.45 mg/dL in non-NODAT patients (P < .001). Serum Mg level was found to be similar in subgroups according to the development period of NODAT (P = .07). When patients were stratified according to quartiles of Mg level, the frequency of NODAT was significantly higher in patients in the lower quartile (Mg < 2.1 mg/dL; P < .001). Older age, high body mass index, and low pretransplant serum Mg levels were established as risk factors for developing NODAT. According to the quartile of Mg level, the risk of developing NODAT was highest in the lowest quartile.
  
  
  CONCLUSIONS
  Pretransplant hypomagnesemia is an independent risk factor of NODAT. Therefore, it is necessary to closely monitor the Mg levels in the posttransplant period.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Istanbul Bilim University, Istanbul, Turkey ayse.sinangil@istanbulbilim.edu.tr.
authors.forename: Ayse
authors.initials: A
authors.lastname: Sinangil
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Istanbul Bilim University, Istanbul, Turkey.
authors.forename: Vedat
authors.initials: V
authors.lastname: Celik
authors.affiliation: Renal Transplantation Unit, Istanbul Bilim University, Istanbul, Turkey.
authors.forename: Soykan
authors.initials: S
authors.lastname: Barlas
authors.affiliation: Clinical Nephrology, Sisli Hamidiye Etfal Research and Educational Hospital, Istanbul, Turkey.
authors.forename: Tamer
authors.initials: T
authors.lastname: Sakaci
authors.affiliation: Clinical Nephrology, Sisli Hamidiye Etfal Research and Educational Hospital, Istanbul, Turkey.
authors.forename: Yener
authors.initials: Y
authors.lastname: Koc
authors.affiliation: Clinical Nephrology, Sisli Hamidiye Etfal Research and Educational Hospital, Istanbul, Turkey.
authors.forename: Taner
authors.initials: T
authors.lastname: Basturk
authors.affiliation: Renal Transplantation Unit, Istanbul Bilim University, Istanbul, Turkey.
authors.forename: Emin Baris
authors.initials: EB
authors.lastname: Akin
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Istanbul Bilim University, Istanbul, Turkey.
authors.forename: Tevfik
authors.initials: T
authors.lastname: Ecder
mesh_terms: D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D016572:Cyclosporine / Q000627:therapeutic use; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007333:Insulin Resistance; D007676:Kidney Failure, Chronic / Q000097:blood / Q000601:surgery*; D016030:Kidney Transplantation; D008274:Magnesium / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D050177:Overweight / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D058570:TOR Serine-Threonine Kinases / Q000037:antagonists & inhibitors; D016559:Tacrolimus / Q000627:therapeutic use; D014883:Water-Electrolyte Imbalance / Q000453:epidemiology*
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine; D058570:TOR Serine-Threonine Kinases; D009173:Mycophenolic Acid; D008274:Magnesium; D016559:Tacrolimus
keywords: NODAT; kidney transplantation; pretransplant hypomagnesemia