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• W2882999920 abstract "Introduction New-onset diabetes after transplantation (NODAT) contributes into cardiovascular disease and infection, reducing graft and patient survival. To improve the outcome of kidney transplant recipients (KTR), it is of great interest to know precisely the incidence of NODAT in KTR. Materials and Methods This study included 63 non-diabetes renal allograft recipients, transplanted from 2010 to 2016 in our department. We assessed the incidence of NODAT. Results We examined all recipients of a kidney transplant in our center between 2010 and 2016 and found an overall NODAT rate of 14.28% (9 patients) in whom 4 patients were diagnosed by 3 months, 3 patients between 6 and 12 months and 2 patients at 24 months. They included 6 males and 3 females of overall mean age of 36.2 years (range, 28-50 years). A positive family history for diabetes was found in 3 patients. Two patients were in overweight (25<=BMI<30). No history of CMV infection was not in these 9 patients. In our study, 8 patients (88.9%) received tacrolimus and 1 patient received cyclosporine. After a mean fallow up of 24 months, graft survival was at 98% in these 9 patients. Discussion It is well established that NODAT usually occurs early after kidney transplantation. One long-term study conducted between 1976 and 2004 in 1580 Egyptian KTR demonstrated a diagnosis of NODAT in 18.2% patients overall, in whom 52.4% were diagnosed by 6 months and 11.5% between 6 and 12 months. A French study of 527 KTR indicated a median time-to-onset of 1.6 months, with an incidence of 7% over 2 years. Incidence estimates in the United States are 9.1% at 3 months, 16% at 12 months, and 24% at 36 months. Non-modifiable risk factors include advancing age, black race, a positive family history for diabetes, and previously diagnosed glucose intolerance. Older age is the strongest and most consistent risk factor for NODAT in kidney transplantation and is reported in the majority of studies. Obesity has been estimated to increase the risk for NODAT. The relationship between NODAT and the immunosuppressive medications used after transplantation has been well documented. The agents most strongly associated with NODAT are corticosteroids and tacrolimus. Increased insulin resistance and weight gain are widely thought to be the main mechanisms involved in corticosteroid-induced NODAT. The association of viral infections (Cytomegalovirus, hepatitis C virus) and NODAT has a long been suggested, although the pathogenetic mechanisms linking this association are poorly understood and further perspective study needs to clarify this issue. Conclusion Regardless of the implications of NODAT for cardiovascular risk, graft function, or mortality, a diagnosis of NODAT carries great significance for the individual patient. Patients should be screened for risk factors before transplantation in order to prospectively tailor their immunosuppression and minimize the risk of NODAT." @default.
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• W2882999920 date "2018-07-01" @default.
• W2882999920 modified "2023-10-06" @default.
• W2882999920 title "New-Onset Diabetes as Complication after Kidney Transplantation; Experience of One Center" @default.
• W2882999920 doi "https://doi.org/10.1097/01.tp.0000543558.75711.80" @default.
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