title: Associations Between Posttransplantation Diabetes Mellitus and Renal Graft Survival.
abstract: Previous reports indicate that posttransplantation diabetes mellitus (PTDM) is associated with overall renal graft loss, but not death-censored graft loss.
  
  
  
  In this single-center retrospective cohort study of 2749 adult Norwegian renal transplant recipients, transplanted between 1999 and 2011, we estimated overall and death-censored renal graft loss hazard ratios in patients diagnosed with PTDM, impaired glucose tolerance and diabetes before transplantation, using multivariable Cox proportional hazard regression analysis.
  
  
  
  A total of 893 renal grafts were lost during the study period, either due to recipient death (n = 540) or death-censored graft loss (n = 353).When the observational time started at time of transplantation, diabetes before transplantation was associated with both overall and death-censored graft loss. Pretransplantation diabetes was also associated with a steeper decline in renal graft function, a higher risk of acute rejections and more renal grafts lost due to acute rejection.In patients with a functional renal graft 1 year after transplantation, PTDM was associated with overall graft loss (hazard ratio, 1.46; 95% confidence interval, 1.13-1.88; P < 0.001), but not death-censored graft loss (hazard ratio, 1.25; 95% confidence interval, 0.80-1.96; P = 0.33). We found no significant associations between PTDM and change in renal function during the first 5 years or acute rejection risk during the first year after renal transplantation.Impaired glucose tolerance was not associated with either overall or death-censored graft loss.
  
  
  
  The present study confirms previous findings of an increased risk of overall but not death-censored renal graft loss in renal transplant recipients with PTDM. Longstanding diabetes might increase the risk of acute rejections.
authors.affiliation: 1 Section of Nephrology, Department of Transplant Medicine, Oslo University Hospital, Rikshospitalet, Norway. 2 Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Norway. 3 The Norwegian Renal Registry, Oslo University Hospital, Rikshospitalet, Norway. 4 Department of Pharmaceutical Biosciences, School of Pharmacy, University of Oslo, Norway. 5 Metabolic and Renal Research Group, UiT The Arctic University of Norway, Tromsø, Norway.
authors.forename: Ivar Anders
authors.initials: IA
authors.lastname: Eide
authors.forename: Thea Anine Strøm
authors.initials: TAS
authors.lastname: Halden
authors.forename: Anders
authors.initials: A
authors.lastname: Hartmann
authors.forename: Dag Olav
authors.initials: DO
authors.lastname: Dahle
authors.forename: Anders
authors.initials: A
authors.lastname: Åsberg
authors.forename: Trond
authors.initials: T
authors.lastname: Jenssen
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D003920:Diabetes Mellitus / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D005260:Female; D006084:Graft Rejection / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D006085:Graft Survival; D006801:Humans; D053208:Kaplan-Meier Estimate; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009664:Norway; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D001786:Blood Glucose