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- Title
Post-Transplant Diabetes Mellitus in Kidney-Transplanted Patients: Related Factors and Impact on Long-Term Outcome.
- Authors
Alfieri, Carlo; Campioli, Edoardo; Fiorina, Paolo; Orsi, Emanuela; Grancini, Valeria; Regalia, Anna; Campise, Mariarosaria; Verdesca, Simona; Delfrate, Nicholas Walter; Molinari, Paolo; Pisacreta, Anna Maria; Favi, Evaldo; Messa, Piergiorgio; Castellano, Giuseppe
- Abstract
This study aimed to investigate the prevalence and determinants of glucose metabolism abnormalities and their impact on long-term clinical outcomes in kidney transplant recipients (KTxps). A retrospective analysis of 832 KTxps (2004–2020) was performed. Patients were assessed at 1 (T1), 6 (T6), and 12 (T12) months post-transplantation and clinically followed for an average of 103 ± 60 months. At T6, 484 patients underwent an oral glucose tolerance test for the diagnosis of alterations in glucose metabolism (AMG+) or post-transplant diabetes mellitus (PTDM+). The prevalence of pre-transplant diabetes was 6.2%, with 22.4% of PTDM+ within the 1st year. Patients with AMG were older and exhibited altered lipid profiles, higher body mass index, and increased inflammatory indices. Age at transplantation, lipid profile, and inflammatory status were significant determinants of PTDM. Graft loss was unaffected by glucose metabolism alterations. Survival analysis demonstrated significantly worse long-term survival for KTxps with diabetes (pre- and PTDM+, p = 0.04). In a comparison of the ND and PTDM+ groups, no significant differences in death with a functioning graft were found. The AMG+ group exhibited worse survival (p < 0.001) than AMG−, even after excluding patients with diabetes mellitus. Future randomized controlled trials are necessary to delve deeper into this subject, specifically examining the effects of new antidiabetic treatments.
- Subjects
DIABETES risk factors; KIDNEY transplantation; RISK assessment; PATIENTS; TRANSPLANTATION of organs, tissues, etc.; DEATH; GLUCOSE tolerance tests; LIPIDS; TREATMENT duration; TREATMENT effectiveness; RETROSPECTIVE studies; DESCRIPTIVE statistics; HYPOGLYCEMIC agents; GLUCOSE metabolism disorders; SURGICAL complications; BLOOD sugar; GRAFT rejection; MEDICAL records; ACQUISITION of data; INFLAMMATION; SURVIVAL analysis (Biometry); COMPARATIVE studies; EVALUATION
- Publication
Nutrients, 2024, Vol 16, Issue 10, p1520
- ISSN
2072-6643
- Publication type
Article
- DOI
10.3390/nu16101520