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. 2011 Apr;40(4):160-7.

Incidence and risk factors for development of new-onset diabetes after kidney transplantation

Yong Mong Bee  1 , Hong Chang Tan, Tunn Lin Tay, Terence Ys Kee, Su Yen Goh, Peng Chin Kek
Affiliations
  • PMID: 21678001
Free article

Incidence and risk factors for development of new-onset diabetes after kidney transplantation

Yong Mong Bee et al. Ann Acad Med Singap. 2011 Apr.
Free article

Abstract

Introduction: New-onset diabetes after transplantation (NODAT) is an increasingly recognised metabolic complication of kidney transplantation that is associated with increased morbidity and mortality. This study aimed to determine the incidence of NODAT and identify risk factors for development of NODAT among kidney allograft recipients in a single centre.

Materials and methods: We retrospectively reviewed all kidney allograft recipients in our centre between 1998 and 2007. NODAT were determined using criteria as per American Diabetes Association guidelines. Logistic regression analyses were performed to identify predictors of NODAT.

Results: Among 388 patients included in the analysis, NODAT was reported in 94 patients (24.2%) after a median follow-up time of 52.1 months. The cumulative incidence of NODAT was 15.8%, 22.8% and 24.5% at 1, 3, and 5 years following transplantation. Seven clinical factors were independent predictors of NODAT: older age, HLA B13 and B15 phenotypes, use of sirolimus, acute rejections, higher pre-transplant and post-transplant (day 1) plasma glucose levels. Patients with NODAT had poorer outcomes in both graft and patient survival.

Conclusion: Our study demonstrates a significant risk and burden of NODAT in an Asian transplant population. Risk stratification and aggressive monitoring of blood glucose early post-transplantation is necessary to identify high-risk patients so that appropriate tailoring of immunosuppression and early institution of lifestyle modifications can be implemented.

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