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New-onset diabetes after transplantation: drug-related risk factors

Abstract: Introduction. New-onset diabetes after transplantation (NODAT), an important complication of renal transplantation leads to reduced graft function and increased patient morbidity and mortality. Because of its high incidence and immense impact on clinical outcomes, prevention of NODAT is highly desirable. Several modifiable and nonmodifiable risk factors for NODAT have been described. The aim of this study was to analyze the influence of various drugs on the development of NODAT during the first year. Methods. A retrospective analysis was performed on 303 adult kidney transplant recipients free of previously known diabetes. NODAT was defined as a fasting plasma glucose level  126 mg/dL confirmed by repeat testing on a different day. We excluded patients with transiently elevated fasting plasma glucose during the first 3 months. Results. NODAT was diagnosed in 37 recipients (12.2%). Univariate analysis identified several variables related to NODAT: recipient age (P  .001), body mass index (P  .001), donor age (P .005), family history of diabetes (P  .001), statin use (P .005), diuretic use (P .040) and tacrolimus therapy (P .029). After multivariate analysis, recipient age (relative risk [RR] 1.060, 95% confidence interval [CI] 1.019 ? 1.102, P .004), family history of diabetes (RR 3.562, 95% CI 1.574 ? 8.058, P .002), smoking habit (RR 2.514, 95% CI 1.118 -5.655, P .026) and diuretic use (RR 2.496, 95% CI 1.087?5.733, P .031) were independently associated with NODAT development. Conclusions. In our population of kidney transplant recipients, the main nonmodifiable risk factors for NODAT were recipient age and a family history of diabetes. Diuretic use was a modifiable risk factor associated with the development of NODAT. To reduce NODAT incidence, it is necessary to consider not only immunosuppressive therapy, but also concomitant drugs such as diuretics.

Otras comunicaciones del congreso o articulos relacionados con autores/as de la Universidad de Cantabria

 Autoría: Santos L., Rodrigo E., Piñera C., Quintella E., Ruiz J.C., Fernández-Fresnedo G., Palomar R., Gómez-Alamillo C., De Francisco A., Arias M.,

 Congreso: Sociedad Española de Trasplante. Congreso (SET) (2º : 2012 : Madrid)

 Editorial: Elsevier

 Año de publicación: 2012

 Nº de páginas: 3

 Tipo de publicación: Comunicación a Congreso

 DOI: 10.1016/j.transproceed.2012.09.053

 ISSN: 0041-1345,1873-2623

Autoría

LIDIA SANTOS ARNAU

VICENTE CELESTINO PIÑERA HACES

QUINTELLA, E.

PALOMAR, ROSA

CARLOS GOMEZ ALAMILLO

ANGEL LUIS MARTIN DE FRANCISCO HERNANDEZ