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    Post-transplant Diabetes Mellitus in Kidney Transplant Recipients: A Multicenter Study.

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    Author
    Malik, Rubab F
    Jia, Yaqi
    Mansour, Sherry G
    Reese, Peter P
    Hall, Isaac E
    Alasfar, Sami
    Doshi, Mona D
    Akalin, Enver
    Bromberg, Jonathan S
    Harhay, Meera N
    Mohan, Sumit
    Muthukumar, Thangamani
    Schröppel, Bernd
    Singh, Pooja
    Weng, Francis L
    Thiessen Philbrook, Heather R
    Parikh, Chirag R
    Show allShow less

    Date
    2021-06-02
    Journal
    Kidney360
    Publisher
    American Society of Nephrology
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://doi.org/10.34067/KID.0000862021
    http://www.ncbi.nlm.nih.gov/pmc/articles/pmc8676388/
    Abstract
    Background: De novo post-transplant diabetes mellitus (PTDM) is a common complication after kidney transplant (KT). Most recent studies are single center with various approaches to outcome ascertainment. Methods: In a multicenter longitudinal cohort of 632 nondiabetic adult kidney recipients transplanted in 2010-2013, we ascertained outcomes through detailed chart review at 13 centers. We hypothesized that donor characteristics, such as sex, HCV infection, and kidney donor profile index (KDPI), and recipient characteristics, such as age, race, BMI, and increased HLA mismatches, would affect the development of PTDM among KT recipients. We defined PTDM as hemoglobin A1c ≥6.5%, pharmacological treatment for diabetes, or documentation of diabetes in electronic medical records. We assessed PTDM risk factors and evaluated for an independent time-updated association between PTDM and graft failure using regression. Results: Mean recipient age was 52±14 years, 59% were male, 49% were Black. Cumulative PTDM incidence 5 years post-KT was 29% (186). Independent baseline PTDM risk factors included older recipient age (P<0.001) and higher BMI (P=0.006). PTDM was not associated with all-cause graft failure (adjusted hazard ratio (aHR), 1.10; 95% CI, 0.78 to 1.55), death-censored graft failure (aHR, 0.85; 95% CI, 0.53 to 1.37), or death (aHR, 1.31; 95% CI, 0.84 to 2.05) at median follow-up of 6 (interquartile range, 4.0-6.9) years post-KT. Induction and maintenance immunosuppression were not different between patients who did and did not develop PTDM. Conclusions: PTDM occurred commonly, and higher baseline BMI was associated with PTDM. PTDM was not associated with graft failure or mortality during the 6-year follow-up, perhaps due to the short follow-up time.
    Rights/Terms
    Copyright © 2021 by the American Society of Nephrology.
    Keyword
    United Network for Organ Sharing (UNOS)
    complication: medical/metabolic
    diabetes: new-onset/post-transplant
    graft survival
    transplantation
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/18484
    ae974a485f413a2113503eed53cd6c53
    10.34067/KID.0000862021
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