NEW-ONSET DIABETES MELLITUS AFTER KIDNEY TRANSPLANTATION: SINGLE CENTER EXPERIENCE

Abstract

New-onset diabetes mellitus after transplantation (NODAT) in kidney transplant recipients promote the development of complications and have a negative impact on kidney transplantation (KT) results. Aim. Comparison of clinico-demographic characteristics and KT results in recipients with and without NODAT. Patients and methods. Study included 439 patients 18+ years without pre-transplantation diabetes who underwent KT from the deceased donor in our center from 01.01.2007 to 31.12.2016. All patients after KT received calcineurin inhibitors and mycophenolate, 322 received tacrolimus (TAK), 117cyclosporin A (CsA). Seventeen recipients received immunosuppression without steroids. Results. NODAT developed in 41 (9.3%) of 439 patients: 33 (10.2%) of 322 on TAK, and 8 of 117 (6.8%) on CsA, p=0.368. The groups with NODAT and without NODAT did not differ in gender, proportion of patients with polycystic kidney disease, modality and duration of dialysis, features of immunosuppression, although there was a tendency for older age and higher body mass index in patients with NODAT. In NODAT group there were significantly more patients with preexisting metabolic syndrome (31.7% versus 12.3%, p = 0.002), post-transplant surgical complications (21.9% vs. 8.5%, p= 0.012), fungal infections (14.6% vs 5.0%, p=0.026), cardiovascular complications (26.8% vs. 9.8%, p=0.003), patients who died with functioning graft (17.1% % vs. 5.5%, p = 0.0012). Recipients and transplants survival was significantly lower in NODAT group (p=0.008, p=0.022, resp.). Conclusion. NODAT negatively affects the results of KT. Prevention, early detection and adequate treatment of NODAT can reduce the incidence of complications after KT and improve recipients and transplants survival.