Incidence and risk factors for post-renal transplant diabetes mellitus

Introduction

Posttransplant diabetes mellitus (PTDM) is a common, serious complication of renal transplantation. The aim of this retrospective study was to estimate the incidence and to identify potential factors predisposing to PTDM.

Patients and methods

We evaluated 296 adult nondiabetic patients who underwent kidney transplantation at our center. PTDM was defined according to 2003 international consensus guidelines. Potential factors predisposing to PTDM were analyzed individually and simultaneously using a logistic regression model.

Results

Over 2054.5 years of cumulative follow-up, 51 patients (17.2%) developed diabetes corresponding to an annual incidence of 2.5%. PTDM was diagnosed after a median of 2.9 months (range: 0.2-168). The mean age of affect individuals was 33.3 ± 7.4 years. Patients with PTDM were significantly older (P < .0005) and showed an higher body mass index (BMI; P < .004). Univariate analysis revealed that age, BMI, family history of diabetes, vascular nephropathy, and hepatitis C infection were associated with PTDM. Multivariate analysis rescaled the roles of age (relative risk [RR] = 1.046/y; P < .04), BMI (RR = 1.107/kg/m², P < .05), vascular nephropathy (RR = 7.06, P < .03), and hepatitis C infection (RR = 2.72, P < .03) as independent factors predisposing to PTDM.

Conclusion

Among our relatively young kidney transplant recipients, in whom only 8% received tacrolimus, PTDM was a frequent complication. We suggest that the use of oral glucose tolerance tests to screen patients identifies those predisposed to develop this complication.