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Review
. 2021 Mar 19;13(3):413.
doi: 10.3390/pharmaceutics13030413.

Current Pharmacological Intervention and Medical Management for Diabetic Kidney Transplant Recipients

Theerawut Klangjareonchai  1   2 , Natsuki Eguchi  1 , Ekamol Tantisattamo  3 , Antoney J Ferrey  3 , Uttam Reddy  3 , Donald C Dafoe  1 , Hirohito Ichii  1
Affiliations
Review

Current Pharmacological Intervention and Medical Management for Diabetic Kidney Transplant Recipients

Theerawut Klangjareonchai et al. Pharmaceutics. .

Abstract

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.

Keywords: cyclosporine; diabetes mellitus; dipeptidyl peptidase-4 (DDP-4) inhibitors; kidney transplant; new onset diabetes after transplantation (NODAT); post-transplant diabetes mellitus (PTDM); tacrolimus.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Pathogenesis and risk factors of glucose metabolism following kidney transplantation and sites of actions of antidiabetic agents. HCV: Hepatitis C virus, CMV: Cytomegalovirus virus, SU: Sulfonylureas, DDP-4: Dipeptidyl Peptidase-4, GLP-1: Glucagon-like peptide-1, TZD: Thiazolidinedione, SGLT-2: Sodium-glucose cotransporter type 2.
Figure 2
Figure 2
Glucose management in pre-, peri-, and late post-transplant periods.
See this image and copyright information in PMC

References

    1. Suthanthiran M., Strom T.B. Renal transplantation. N. Engl. J. Med. 1994;331:365–376. doi: 10.1056/NEJM199408113310606. - DOI - PubMed
    1. Schnuelle P., Lorenz D., Trede M., Van Der Woude F.J. Impact of renal cadaveric transplantation on survival in end-stage renal failure: Evidence for reduced mortality risk compared with hemodialysis during long-term follow-up. J. Am. Soc. Nephrol. 1998;9:2135–2141. - PubMed
    1. Yang F., Liao M., Wang P., Yang Z., Liu Y. The Cost-Effectiveness of Kidney Replacement Therapy Modalities: A Systematic Review of Full Economic Evaluations. Appl. Health Econ. Health Policy. 2020;19:163–180. doi: 10.1007/s40258-020-00614-4. - DOI - PMC - PubMed
    1. Voora S., Adey D.B. Management of Kidney Transplant Recipients by General Nephrologists: Core Curriculum 2019. Am. J. Kidney Dis. 2019;73:866–879. doi: 10.1053/j.ajkd.2019.01.031. - DOI - PubMed
    1. Kasiske B.L., Snyder J.J., Gilbertson D., Matas A.J. Diabetes mellitus after kidney transplantation in the United States. Am. J. Transpl. 2003;3:178–185. doi: 10.1034/j.1600-6143.2003.00010.x. - DOI - PubMed