Diabetes mellitus after kidney transplantation: a French multicentre observational study.

Abstract

BACKGROUND:

New-onset diabetes mellitus (NODM)-a common complication of kidney transplantation-is associated with increases in graft loss, morbidity and mortality.

METHODS:

This is a purely observational study of 527 patients taking a calcineurin inhibitor (CNI), based on data collected at a single routine visit 6-24 months after kidney transplantation. Diabetes was defined according to ADA/WHO guidelines.

RESULTS:

The mean age of the patients was 47.2 years and 61.1% were men; 49.5% were receiving cyclosporine microemulsion (CsA-ME) and 50.5% tacrolimus (Tac). NODM developed in 7.0% after a median interval of 1.6 months. In CsA-ME-treated patients, the unadjusted cumulative risks of NODM were 5.5% and 8.4% at 1- and 2-year post-transplantation, while in Tac-treated patients, the risks were respectively 17.4% and 21%. Four independent risk factors (RFs) were identified by multivariate analysis: maximum lifetime body mass index>25 [odds ratio (OR)=5.1], pre-transplantation impaired fasting glucose (OR=4.7), hepatitis C status (OR=4.7) and Tac vs CsA-ME treatment (OR=3.0).

CONCLUSIONS:

NODM is associated with certain RFs present prior to kidney transplantation, and with treatment with Tac as opposed to CsA-ME.

• Authors: Nassim Kamar, Christophe Mariat, Michel Delahousse, Jacques Dantal, Azmi Al Najjar, Elisabeth Cassuto, Nicole Lefrançois, Olivier Cointault, Guy Touchard, Florence Villemain, Fabienne Di Giambattista, Pierre-Yves Benhamou, Diapason Study Group
• Journal: Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association (Nephrol Dial Transplant) Vol. 22 Issue 7 Pg. 1986-93 (Jul 2007) ISSN: 0931-0509 [Print] England
• PMID: 17400559 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)

Chemical References

• Blood Glucose
• Calcineurin Inhibitors
• Emulsions
• Immunosuppressive Agents
• Cyclosporine
• Tacrolimus

Topics

• Adult
• Blood Glucose (metabolism)
• Body Mass Index
• Calcineurin Inhibitors
• Cyclosporine (administration & dosage, therapeutic use)
• Diabetes Mellitus (epidemiology, etiology, therapy)
• Emulsions
• Fasting (blood)
• Female
• France (epidemiology)
• Hepatitis C (complications)
• Humans
• Immunosuppressive Agents (adverse effects, therapeutic use)
• Incidence
• Kidney Diseases (complications, surgery)
• Kidney Transplantation (adverse effects)
• Male
• Middle Aged
• Retrospective Studies
• Risk Factors
• Tacrolimus (adverse effects, therapeutic use)
• Time Factors