Abstract
Post-transplant diabetes mellitus (PTDM) is associated with infection, cardiovascular morbidity, and mortality. A retrospective cohort study involving patients who underwent renal transplantation in a transplantation center in Taiwan from January 2000 to December 2018 was conducted to investigate the incidence and risk factors of PTDM and long-term patient and graft survival rates. High age (45–65 vs. <45 years, adjusted odds ratio (aOR) = 2.90, 95% confidence interval (CI) = 1.64–5.13, p < 0.001), high body mass index (>27 vs. <24 kg/m2, aOR = 5.35, 95% CI = 2.75–10.42, p < 0.001), and deceased organ donor (cadaveric vs. living, aOR = 2.01, 95% CI = 1.03–3.93, p = 0.04) were the three most important risk factors for the development of PTDM. The cumulative survival rate of patients and allografts was higher in patients without PTDM than in those with PTDM (p = 0.007 and 0.041, respectively). Concurrent use of calcineurin inhibitors and mammalian target of rapamycin inhibitors (mTORis) decreased the risk of PTDM (tacrolimus vs. tacrolimus with mTORi, aOR = 0.28, 95% CI = 0.14–0.55, p < 0.001). Investigating PTDM risk factors before and modifying immunosuppressant regimens after transplantation may effectively prevent PTDM development.
Highlights
Post-transplant diabetes mellitus (PTDM) is a common and severe complication in patients who receive immunosuppressive agents after kidney transplantation, and this has a major effect on graft and patient outcomes [1,2,3,4]
Recipients were divided into four groups according to the Immunosuppressant Regimens (IMRs) received to analyze the correlation and hazards linking IMRs and PTDM: FK group, tacrolimus-based regimen; CsA group, cyclosporine-based regimen; FK + mammalian target of rapamycin inhibitors (mTORis) group, tacrolimus-based regimen combined with an mTORi; and CsA + mTORi group, cyclosporine-based regimen combined with an mTORi
This study revealed that high age and body mass index (BMI) at transplantation and receiving an organ from a deceased donor were the three most important risk factors for developing PTDM
Summary
Post-transplant diabetes mellitus (PTDM) is a common and severe complication in patients who receive immunosuppressive agents after kidney transplantation, and this has a major effect on graft and patient outcomes [1,2,3,4]. Public Health 2020, 17, 4581; doi:10.3390/ijerph17124581 www.mdpi.com/journal/ijerph
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