The risk factors and outcome of posttransplantation initial diabetes mellitus in living donor renal transplantation: a single center retrospective study / 中华器官移植杂志

ABSTRACT

Objective To investigate the risk factors of posttransplantation initial diabetes mellitus(PTDM) and the prognostic impact on living donor renal transplantation recipients.Methods The clinical data of 273 living donor renal transplantation recipients from 2007 to 2013 were retrospectively studied.Recipients were divided into PTDM group and non-PTDM group according to the diagnostic standard.Potential risk factors were analyzed by logistic regression model.The incidence of adverse events were analyzed and compared between the two groups.Recipients and grafts survival (overall and death-censored) rate was analyzed by Kaplan-Meier method.Results During the 5-year follow-up period,62 out of total 273 relative-living recipients were diagnosed as PTDM (22.71％).Six risk factors for PTDM were identified:BMI ≥25 kg/m2 (OR,3.911;95％CI,1.811-8.445),male gender (OR,2.291;95％CI,1.184-4.436),family history of diabetes (OR,3.225;95％CI,1.447-7.186),ARE (OR,4.481;95％CI,1.908-10.522),administration of tacrolimus (OR,3.678;95％CI,1.807-7.483) and impaired fasting glucose (IFG) diagnosed at 1st week posttransplantation (OR,3.925;95 ％ CI,1.997-7.716).The infection rate was significantly higher in PTDM group than in non-PTDM (16.12％ vs.7.11 ％,P =0.045).No significant difference was observed in both patient and graft survival (both overall and death-censored graft survival) rate during the 5-year follow-up period.Conclusion PTDM was associated with multiple risk factors,including male,high BMI,IFG during 1st week after transplantation,ARE,tacrolimus administration and family diabetes history.PTDM increased the infection incidence but did not affect both recipient and allograft survival significantly during the 5-year follow-up period.