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Submitted: 03 Aug 2020
Accepted: 15 Oct 2020
ePublished: 23 Nov 2020
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J Renal Inj Prev. 2021;10(2): e14-e14.
doi: 10.34172/jrip.2021.14

Original

Post-transplantation diabetes mellitus after kidney transplantation and its related factors in Iranian patients: a retrospective single-center study

Elham Ramezanzadeh 1 ORCID logo, Azin Tirbakhsh 1 ORCID logo, Ali Monfared 1 ORCID logo, Masoud Khosravi 1 * ORCID logo, Mohammadkazem Lebadi 1 ORCID logo, Behrang Motamed 1 ORCID logo, Gholamreza Mokhtari 1 ORCID logo, Ehsan Kazemnezhad Leyli 1 ORCID logo

1 Razi Clinical Research Development Center, School of Medicine, Razi hospital, Guilan University of Medical Sciences, Rasht, Iran
*Corresponding author: Masoud Khosravi, Email: drmasoudkhosravi@gmail.com & masoud@gums.ac.ir

Abstract

Introduction: Post-transplantation diabetes mellitus (PTDM) is a metabolic complication following transplantation, which is associated with cardiovascular disease and leads to increased post-ttransplantation morbidity and mortality.

Objectives: To identify the incidence of PTDM and its risk factors in kidney recipients at a single-center in Iran.

Patients and Methods: This retrospective study was conducted on 379 kidney recipients with a negative history of diabetes mellitus who underwent transplant before January 2017. PTDM was defined according to the diagnostic criteria of the American Diabetes Association (ADA) and the World Health Organization (WHO). Data on demographic, clinical characteristics and laboratory parameters were collected. Kaplan-Mayer analysis was used to evaluate the cumulative incidence of PTDM. The association between risk factors and PTDM incidence was identified with stepwise Cox regression.

Results: The cumulative incidence of PTDM during a 24-month follow-up was 30.1% (95% CI: 25.6-34.8). By univariate analysis, modifiable or non-modifiable risk factors for PTDM development included recipient age, body mass index (BMI), marital status, family history of diabetes, smoking, type of transplant, hepatitis C virus (HCV), cytomegalovirus (CMV), transplant rejection, TG, tacrolimus, cyclosporine and beta blocker. In this study, family history of diabetes, type of transplant, HCV, CMV, TG, tacrolimus, and beta blocker were predictors of development of PTDM in Cox proportional hazard models.

Conclusion: The incidence of PTDM was high. Identification of risk factors determines appropriate strategies for PTDM incidence risk reduction.

Keywords: Ciclosporin, Immunosuppression, Posttransplantation diabetes mellitus, Renal-transplantation diabetes mellitus, Renal transplantation, Tacrolimus
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