Increased risk of post-transplant diabetes mellitus despite early steroid discontinuation in Hispanic kidney transplant recipients

2005 ◽  
Vol 19 (4) ◽  
pp. 527-531 ◽  
Author(s):  
Debra A Walczak ◽  
Denise Calvert ◽  
Tomasz M Jarzembowski ◽  
Giuliano Testa ◽  
Howard N Sankary ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Kidney Transplant ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Post Transplant ◽  
Increased Risk

scholarly journals Current Pharmacological Intervention and Medical Management for Diabetic Kidney Transplant Recipients

Pharmaceutics ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 413
Author(s):  
Theerawut Klangjareonchai ◽  
Natsuki Eguchi ◽  
Ekamol Tantisattamo ◽  
Antoney J. Ferrey ◽  
Uttam Reddy ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Kidney Transplantation ◽  
Kidney Transplant ◽  
Pharmacological Intervention ◽  
Diabetic Patients ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Kidney Allograft ◽  
Post Transplant ◽  
Glucose Management

Hyperglycemia after kidney transplantation is common in both diabetic and non-diabetic patients. Both pretransplant and post-transplant diabetes mellitus are associated with increased kidney allograft failure and mortality. Glucose management may be challenging for kidney transplant recipients. The pathophysiology and pattern of hyperglycemia in patients following kidney transplantation is different from those with type 2 diabetes mellitus. In patients with pre-existing and post-transplant diabetes mellitus, there is limited data on the management of hyperglycemia after kidney transplantation. The following article discusses the nomenclature and diagnosis of pre- and post-transplant diabetes mellitus, the impact of transplant-related hyperglycemia on patient and kidney allograft outcomes, risk factors and potential pathogenic mechanisms of hyperglycemia after kidney transplantation, glucose management before and after transplantation, and modalities for prevention of post-transplant diabetes mellitus.

scholarly journals Graft Function, Albuminuria, and the Risk of Hemorrhage and Thrombosis After Kidney Transplantation

2020 ◽  
Vol 7 ◽  
pp. 205435812095219
Author(s):  
Rachel Jeong ◽  
Robert R. Quinn ◽  
Pietro Ravani ◽  
Feng Ye ◽  
Manish M. Sood ◽  
...  
Keyword(s):  
Cohort Study ◽  
Venous Thrombosis ◽  
Kidney Transplant ◽  
Graft Function ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Post Transplant ◽  
Increased Risk ◽  
Lower Egfr ◽  
Risk Of Hemorrhage

Background: Compared to the general population, kidney transplant recipients are at increased risk of hemorrhage and thrombosis. Whether this risk is affected by graft function and albuminuria is unknown. Objective: To determine the association between graft function and albuminuria and the risk of post-transplant hemorrhage and thrombosis. Design: Retrospective cohort study. Setting: We used linked health care databases in Alberta, Canada. Patients/sample/participants: We included adult kidney transplant recipients from 2002 to 2015 with a functioning graft at 1 year. Measurements: Estimated glomerular filtration rate (eGFR) and albuminuria measurements at 1 year post-transplant were used to categorize recipients (eGFR: ≥45 vs. <45 mL/min/1.73 m2; albuminuria: absence vs. presence). We determined the rates of post-transplant hemorrhage and venous thrombosis based on validated diagnostic and procedural codes. Methods: We determined the association between categories of eGFR and albuminuria and post-transplant hemorrhage and venous thrombosis using Poisson regression with log link. Results: Of 1284 kidney transplant recipients, 21% had an eGFR <45 mL/min/1.73 m2 and 40% had presence of albuminuria at 1 year post-transplant. Over a median follow-up of 6 years, there were 100 hemorrhages (12.6 events per 1000 person-years) and 57 venous thrombosis events (7.1 events per 1000 person-years). The age- and sex-adjusted rate of hemorrhage and thrombosis was over 2-fold higher in recipients with lower eGFR and presence of albuminuria compared to higher eGFR and no albuminuria (hemorrhage: incidence rate ratio, IRR, 2.6, 95% confidence interval [CI]: 1.5-4.4, P = .001; thrombosis: IRR, 2.3, 95% CI: 1.1-5.0, P = .046). Limitations: Complete relevant medication information, such as anticoagulants, were not available in our datasets. Due to sample size, this study was underpowered to conduct a fully adjusted analysis. Conclusion: Among kidney transplant recipients, lower eGFR and presence of albuminuria at 1 year post-transplant were associated with an over 2-fold higher risk of hemorrhage and venous thrombosis. Graft function and albuminuria at 1 year post-transplant are important prognostic factors in determining risk of post-transplant hemorrhage and venous thrombosis. Further research, including medication data, are needed to further delineate outcomes and safety. Trial registration: Not applicable (cohort study).

RACIAL IMPACT ON THE RATE OF POST-TRANSPLANT DIABETES MELLITUS IN STEROID-FREE KIDNEY TRANSPLANT RECIPIENTS

2004 ◽  
Vol 78 ◽  
pp. 313
Author(s):  
E Benedetti ◽  
D Walczak ◽  
D Calvert ◽  
T M. Jarzembowski ◽  
G Testa ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Kidney Transplant ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Post Transplant

Incidence and Risk Factors of Post Transplant Diabetes Mellitus in Kidney Transplant Recipients in Qatar

2018 ◽  
Vol 102 ◽  
pp. S648
Author(s):  
Mohamad Alkadi ◽  
Shaefiq Thappy ◽  
Essa Abuhelaiqa ◽  
Jehan Mahmoud ◽  
Mona Jarman ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Kidney Transplant ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Post Transplant

Efficacy and Safety of Dipeptidyl Peptidase-4 Inhibitors in Kidney Transplant Recipients with Post-transplant Diabetes Mellitus (PTDM)- a Systematic Review and Meta-Analysis

2020 ◽  
Vol 16 (6) ◽  
pp. 580-585 ◽  
Author(s):  
Tarek Samy Abdelaziz ◽  
Ahmed Yamany Ali ◽  
Moataz Fatthy
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Kidney Transplant ◽  
Meta Analysis ◽  
Mean Difference ◽  
Efficacy And Safety ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Dipeptidyl Peptidase 4 ◽  
Post Transplant

Background: Kidney transplant recipients may develop post-transplant diabetes mellitus (PTDM). Dipeptidyl peptidase 4(DPP-4) inhibitors are evolving agents in the management of patients with diabetes mellitus. Aims: To evaluate the efficacy and safety of DPP-4 inhibitors in the management of post-transplant diabetes mellitus (PTDM) in renal transplant recipients. Methods: We performed a systematic search of the electronic databases using keys words and Mesh terms. Data were extracted and reviewed using structured proforma. A comprehensive review of the eligible studies was performed independently by each of two reviewers; conflicts were resolved by the third reviewer. The primary efficacy endpoint was the difference in glycosylated hemoglobin (HbA1c) comparing any of the DPP-4 inhibitors to either placebo or other hypoglycaemic agent. The primary safety endpoints were the worsening of graft functions and change in Tacrolimus trough level. We performed the Random effect model using standardised mean difference. Results: We identified seven studies that were eligible for the systematic review; only one study compared Sitagliptin to insulin Glargine. One study involved head to head comparison of three DPP-4 inhibitors. The other five studies were pooled in the meta-analysis. DPP-4 inhibitors had a favourable glycemic effect as measured by HbA1c when compared to either placebo or oral anti-hyperglycemic medications (standardised mean difference in HbA1c = -0.993, 95% CI= -1.303 to -0.683, P=0.001). DPP-4 inhibitors use did not result in significant change in eGFR ((standardised mean difference = 0.147, 95% CI= -0.139 - 0.433, p=0.312).) nor Tacrolimus level (standardised Mean Difference= 0.152, 95% CI= -0.172 to 0.477, P=0.354). Conclusion: Current evidence supports the short term efficacy and safety of DDP-4 inhibitor agents in the management of post transplantation diabetes mellitus (PTDM) in kidney transplant recipients. However, more RCTs are required to investigate the long-term safety and efficacy of these agents in kidney transplant recipients.

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