Clinical Variables and Outcomes of Kidney Transplant Recipients with Type 2 Diabetes and New-Onset Diabetes after Transplantation in a Predominantly Minority Urban Population

Abstract

Background: Minority populations remain at a high risk for type 2 diabetes (T2D) and its complications. In kidney transplant recipients T2D and new onset diabetes after transplant (NODAT) are associated with worse outcomes, but data from minority populations are limited. We aimed to characterize clinical variables and outcomes in a predominantly minority kidney transplant recipients with T2D and NODAT. Methods: We performed a retrospective chart review of all recipients of kidney transplant in a large urban university center from June 01, 2012 until December 31, 2014. Individuals with type 1 diabetes or pancreas transplant were excluded. NODAT was defined by the ADA criteria. Results: We included 304 individuals, 40% Hispanic and 41% non-Hispanic black. Fifty percent had T2D. During a median follow-up of 37 (22-52) months, 36% of the recipients without diabetes developed NODAT. Hispanics and non-Hispanic blacks less frequently remained without diabetes compared to non-Hispanic whites (27% vs. 29% vs. 51%, p=0.001). Individuals with T2D had higher BMI compared to NODAT and no diabetes (29.9±7.4 vs. 28.1±6.5 vs. 27.2±5.7kg/m2, p=0.007). Individuals with T2D and NODAT were older than those without diabetes (60.8±9.5 vs. 56.5±13 vs. 47.9±14 years, p<0.0001), had more pretransplant cardiovascular disease (36 vs. 26 vs. 11%, p<0.0001), more deceased-donor transplants (90 vs. 93 vs. 75%, p=0.0007), and had significantly higher proteinuria at 6, 12, and 24 months posttransplant, but no difference was found in serum creatinine, graft survival (94 vs. 94 vs. 93%, p=0.904) or patient survival (93 vs. 96 vs. 95%, p=0.708). Conclusions: In a predominantly minority cohort there was a high rate of both T2D and NODAT with only less than one fifth of individuals without diabetes. In this high-risk population, there was no difference in patient or graft survival over a relatively short observational period. Disclosure S. Aleksic: None. S. Zahedpour Anaraki: None. E. Tsomos: None. L. Upadhyay: None. E. Japp: None. M. Ajaimy: None. E. Akalin: None. J. Zonszein: Speaker's Bureau; Self; Novo Nordisk Inc.. Advisory Panel; Self; Merck & Co., Inc.. Speaker's Bureau; Self; Boehringer Ingelheim Pharmaceuticals, Inc..