Journal article
Post-transplant Diabetes Mellitus in Kidney Transplant Recipients: A Multicenter Study
Kidney360, v 2(8), pp 1296-1307
26 Aug 2021
PMID: 35369651
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
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.
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.
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 (
<0.001) and higher BMI (
=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.
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.
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Details
- Title
- Post-transplant Diabetes Mellitus in Kidney Transplant Recipients: A Multicenter Study
- Creators
- Rubab F Malik - Johns Hopkins MedicineYaqi Jia - Johns Hopkins MedicineSherry G Mansour - Yale UniversityPeter P Reese - University of PennsylvaniaIsaac E Hall - University of Utah Health CareSami Alasfar - Johns Hopkins MedicineMona D Doshi - University of MichiganEnver Akalin - Montefiore Medical CenterJonathan S Bromberg - University of Maryland School of Medicine, United States.Meera N Harhay - Drexel UniversitySumit Mohan - Columbia UniversityThangamani Muthukumar - Presbyterian HospitalBernd Schröppel - University Hospital UlmPooja Singh - Thomas Jefferson University HospitalFrancis L Weng - Saint Barnabas Medical CenterHeather R Thiessen Philbrook - Johns Hopkins University School of MedicineChirag R Parikh - Johns Hopkins Medicine
- Publication Details
- Kidney360, v 2(8), pp 1296-1307
- Grant note
- KL2 TR002539 / NCATS NIH HHS P30 DK079310 / NIDDK NIH HHS K24 DK090203 / NIDDK NIH HHS
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Medicine
- Web of Science ID
- WOS:000884317800010
- Scopus ID
- 2-s2.0-85141294646
- Other Identifier
- 991019335502404721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Urology & Nephrology