Pre-existing but not post-solid organ transplantation diabetes mellitus predicts end stage renal disease and mortality
- PMID: 40802011
- DOI: 10.1007/s00210-025-04496-y
Pre-existing but not post-solid organ transplantation diabetes mellitus predicts end stage renal disease and mortality
Abstract
This study examined patients who underwent solid organ transplantation (SOT) within a large healthcare system in Taiwan, with the objective of comparing the risks of adverse outcomes, specifically end-stage renal disease (ESRD) and mortality. The study aimed to assess whether type 2 diabetes mellitus (T2DM), occurring either before or after SOT, serves as a prognostic factor in this particular population. The study cohort comprised 3,675 non-T2DM patients, 2,261 patients with pre-existing T2DM, and 358 patients who developed T2DM post-SOT. Univariable and multivariable Cox proportional hazards regression models were employed to evaluate the impact of risk factors on the likelihood of developing ESRD or death, with results expressed as hazard ratios (HR) accompanied by 95% confidence intervals (CI). The group with pre-existing T2DM exhibited a higher risk of ESRD and mortality compared to the non-T2DM group (adjusted HR (aHR) = 2.14, 95% CI (1.44, 3.19); aHR = 1.37, 95% CI (1.12, 1.68)). Conversely, the post-SOT T2DM group did not demonstrate an increased risk of ESRD and mortality relative to the non-T2DM group (aHR = 0.95, 95% CI (0.45, 1.59); aHR = 1.23, 95% CI (0.93, 1.61)). Additionally, the risk of ESRD and death was elevated in the pre-existing T2DM group within the liver transplant cohort (aHR = 2.07, 95% CI (1.28, 3.35); aHR = 1.35, 95% CI (1.07, 1.71)). Pre-SOT T2DM may serve as a predictor of ESRD and all-cause mortality, particularly for those undergoing liver transplantation.
Keywords: End stage renal disease; Mortality; Solid organ transplantation.
© 2025. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
Conflict of interest statement
Declarations. Clinical trial number: Not applicable. Human ethics: This study complies with the Declaration of Helsinki. Consent to participate: Not required. Ethical approval: The study received approval from the Research Ethics Committee of China Medical University and Hospital (CMUH111-REC2-109(CR-1)). Consent to participate: Not required. Consent for publication: Not required. Competing interests: The authors declare no competing interests. Disclaimer: The funders had no involvement in the study design, data collection and analysis, decision to publish, or manuscript preparation.
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References
-
- American Society of Transplantation (2001) In: Norman DJ, Turka LA (eds) Primer on transplantation, vol 2. Wiley, New York, p 732
-
- Bertoux F, On behalf of the EBPG Expert Group on Renal Transplantation (2002) European best practice guidelines on renal transplantation. Part 2. Nephrol Dial Transplant 17(4):1–67
-
- Borda B, Lengyel C, Szederkényi E, Eller J, Keresztes C, Lázár G (2012) Post-transplant diabetes mellitus - risk factors and effects on the function and morphology of the allograft. Acta Physiol Hung 99(2):206–215 - PubMed
-
- Busuttil RW (2005) In: Busuttil W, Klintmalm GB (eds) Transplantation of the liver, vol 2. Sounders, Philadelphia, p 1485
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