A new scoring system to predict the incidence of new onset diabetes after transplantation (NODAT)

Abstract

Background. We performed this study to develop a new scoring system to stratify different levels of risk of developing new onset diabetes after transplantation (NODAT) in patients who underwent renal transplantation. Many prognostic variables have been previously described but few efforts have been made to group them in order to enhance their individual predictive power. Material and methods. In a first phase, 100 patients were prospectively analysed to determine which factors were significantly associated with the development of NODAT. A risk score ranging from 0 to 10 points was developed using a multivariate analysis. In a second phase, such score was validated in a new sample of 100 patients. Results. BMI ≥ 23.5 kg/m 2 , age ≥ 38.5 years, fasting blood sugar at 1 st post-operative day ≥ 159.5 mg/dL, fasting blood sugar at 5th post-operative day ≥ 122.5 mg/dL and HOMA-IR ≥ 2.5 were found as independent prognostic variables. A clear distinction was shown among categories of low, intermediate and high risk, defined according to the risk score. Conclusion. This new scoring framework is basic and simple to accomplish. It permits a generally excellent stratification of risk of developing NODAT in patients undergoing renal transplantation. They might be separated in three risk stratification cohorts, which could be of help in early identification of NODAT.