Post-transplant Diabetes Mellitus in Kidney Transplant Recipients: A Multicenter Study.
Author
Malik, Rubab FJia, 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
Date
2021-06-02Journal
Kidney360Publisher
American Society of NephrologyType
Article
Metadata
Show full item recordAbstract
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/10713/18484ae974a485f413a2113503eed53cd6c53
10.34067/KID.0000862021