title: Hypomagnesemia and increased risk of new-onset diabetes mellitus after transplantation in pediatric renal transplant recipients.
abstract: New-onset diabetes after transplantation (NODAT) is a significant co-morbidity following kidney transplantation. Lower post-transplant serum magnesium levels have been found to be an independent risk factor for NODAT in adult kidney transplant recipients.
  
  
  
  We undertook a retrospective analysis of risk factors for NODAT in pediatric renal transplant recipients at our institution with the aim of determining if hypomagnesemia confers a significant risk of developing NODAT in this patient population.
  
  
  
  A total of 173 children with a median age at transplantation of 7.0 (range 1.3-17.5) years were included. Hypomagnesemia was found to be a significant independent risk factor for NODAT (p = 0.01). High trough tacrolimus levels were also independently associated with NODAT (p < 0.001). There was no significant association between NODAT and body mass index at the time of transplantation, monthly cumulative steroid dose or post-transplant cytomegalovirus viremia (p = 0.9, 0.6 and 0.7, respectively).
  
  
  
  This study identifies hypomagnesemia as a significant independent risk factor for the development of NODAT in pediatric renal transplant recipients. Given the clear association between hypomagnesemia and NODAT in both adults and children following renal transplantation, further studies are merited to clarify the etiology of this association and to examine the effect of magnesium supplementation on NODAT.
authors.affiliation: Great Ormond Street Hospital for Children, London, WC1N 3JH, UK. Wesley.hayes@gosh.nhs.uk.|University College London Institute of Child Health, London, UK. Wesley.hayes@gosh.nhs.uk.
authors.forename: Wesley
authors.identifier: 0000-0002-8091-6945
authors.initials: W
authors.lastname: Hayes
authors.affiliation: Great Ormond Street Hospital for Children, London, WC1N 3JH, UK.
authors.forename: Sheila
authors.initials: S
authors.lastname: Boyle
authors.affiliation: Great Ormond Street Hospital for Children, London, WC1N 3JH, UK.
authors.forename: Adrian
authors.initials: A
authors.lastname: Carroll
authors.affiliation: Great Ormond Street Hospital for Children, London, WC1N 3JH, UK.|University College London Institute of Child Health, London, UK.
authors.forename: Detlef
authors.initials: D
authors.lastname: Bockenhauer
authors.affiliation: Great Ormond Street Hospital for Children, London, WC1N 3JH, UK.|University College London Institute of Child Health, London, UK.
authors.forename: Stephen D
authors.initials: SD
authors.lastname: Marks
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D003586:Cytomegalovirus Infections / Q000097:blood / Q000150:complications; D003920:Diabetes Mellitus / Q000209:etiology*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007223:Infant; D016030:Kidney Transplantation / Q000009:adverse effects*; D008275:Magnesium Deficiency / Q000097:blood / Q000150:complications*; D008297:Male; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D013256:Steroids / Q000009:adverse effects / Q000627:therapeutic use; D016559:Tacrolimus / Q000627:therapeutic use; D066027:Transplant Recipients
chemical_list: D007166:Immunosuppressive Agents; D013256:Steroids; D016559:Tacrolimus
keywords: Children; Diabetes; Hypomagnesemia; Kidney transplantation; Tacrolimus