Korean J Transplant.  2020 Dec;34(4):231-237. 10.4285/kjt.20.0026.

Incidence and relative risk factors in posttransplant diabetes mellitus patients: a retrospective cohort study

Affiliations
  • 1Department of Pharmacy, Taichung Veterans General Hospital, Taichung City, Taiwan
  • 2School of Pharmacy, China Medical University, Taichung City, Taiwan
  • 3Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung City, Taiwan
  • 4Department of Pharmacy, Chi Mei Medical Center, Tainan City, Taiwan
  • 5Department of Pharmacy, Chia Nan University of Pharmacy and Science, Tainan City, Taiwan

Abstract

Background
Posttransplant diabetes mellitus (PTDM) has a long-term impact on kidney transplantation outcomes, such as graft and patient survival. The incidence and risk factors of PTDM are well studied, but long-term follow-up results remain unavailable. We examined the long-term incidence and relative risk factors of PTDM.
Methods
A hospital information system database for kidney transplant recipients (KTRs) for a transplantation center between 1983 and 2018 was used to perform this retrospec-tive cohort study. KTRs with DM diagnosis and continuous use of hypoglycemic agents for more than 3 months were defined as having PTDM. Demographics and comorbidities before transplantation were also collected. Kaplan-Meier analyses were used to determine the cumulative incidence and relative risk factors.
Results
A total of 296 PTDM cases were confirmed (28.46%) in this study. An increased cumulative incidence associated with age was noted, which was significantly increased in those aged ≥40 years. Male sex, hypertension, hyperlipidemia before transplantation, cytomegalovirus (CMV) infection, and tacrolimus-based regimens were also risk factors. No significant correlation was found between the development of PTDM and the increase of human leukocyte antigen mismatches, the primary causes of end-stage renal disease, and acute rejection.
Conclusions
PTDM incidence was high in this cohort study. Characteristics such as age ≥40 years, tacrolimus use, comorbidity of hypertension and hyperlipidemia before trans-plantation, and CMV infection were associated with a high risk of PTDM. Monitoring and adjusting preventable risk factors such as CMV infection might be useful to prevent PTDM.

Keyword

Incidence; Posttransplant diabetes mellitus; Risk factors
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