Carranza-Ruelas BE, Martínez-Mier G, Escobar-Ríos AY

Language: Spanish
References: 14
Page: 12-17
PDF size: 227.59 Kb.

ABSTRACT

Introduction: Postransplant diabetes mellitus (PTDM) is a little studied complication in renal graft recipients, and its causes are still controversial. Objective: To identify and define the risk factors in the presentation of PTDM in patients receiving renal transplantation in UMAE 14 Veracruz, Mexico. Material and methods: An observational and ambiprospective study protocol was carried out to patients receiving kidney transplants in UMAE 14, in the period from March 2015 to December 2016. Results: 496 renal transplant patients with ages between 18 and 66 years participated, with an average of 33.02 years. 58.7% were men, 70% had a BMI in the normal range, 79% with an etiology of undetermined kidney disease, of which 120 of the recipients and 93 of the donors with cytomegalovirus (CMV) were found. 68% of the transplants were from a live donor, 76% of the patients received induction to transplant with basiliximab and 55% continued treatment with cyclosporine. We found a relation to the presentation of PTDM of risk factors such as male gender, BMI in overweight, age range of 50 to 59 years, polycystic kidney disease, CMV in the recipient and in the donor, as well as the combined use of induction to transplant with basiliximab and immunosuppressive treatment with tacrolimus. Conclusion: An incidence of DM after transplant of 3.2% was found and we were able to identify the most commonly associated factors.

REFERENCES

1. Starzl T, Holmes J. Experience in renal transplantation. Philadelphia: Saunders; 1964. p. 111.

2. Pham PT, Edling KL, Chakkera HA, Pham PC, Pham PM. Screening strategies and predictive diagnostic tools for the development of new-onset diabetes mellitus after transplantation: an overview. Diabetes Metab Syndr Obes. 2012; 5: 379-387.

3. Davidson J, Wilkinson A, Dantal J, Dotta F, Haller H, Hernández D et al. New-onset diabetes after transplantation: 2003 International consensus guidelines. Proceedings of an international expert panel meeting. Barcelona, Spain, 19 February 2003. Transplantation. 2003; 75 (10 Suppl): SS3-S24.

4. Sharif A, Hecking M, de Vries AP, Porrini E, Hornum M, Rasoul-Rockenschaub S et al. Proceedings from an international consensus meeting on posttransplantation diabetes mellitus: recommendations and future directions. Am J Transplant. 2014; 14 (9): 1992-2000.

5. Kaposztas Z, Gyurus E, Kahan BD. New-onset diabetes after renal transplantation: diagnosis, incidence, risk factors, impact on outcomes, and novel implications. Transplant Proc. 2011; 43 (5): 1375-1394.

6. Santos L, Rodrigo E, Piñera C, Quintella E, Ruiz JC, Fernández-Fresnedo G et al. New-onset diabetes after transplantation: drug-related risk factors. Transplant Proc. 2012; 44 (9): 2585-2587.

7. Hecking M, Kainz A, Werzowa J, Haidinger M, Döller D, Tura A et al. Glucose metabolism after renal transplantation. Diabetes Care. 2013; 36 (9): 2763-2771.

8. Yates CJ, Fourlanos S, Hjelmesaeth J, Colman PG, Cohney SJ. New-onset diabetes after kidney transplantation-changes and challenges. Am J Transplant. 2012; 12 (4): 820-828.

9. First MR, Dhadda S, Croy R, Holman J, Fitzsimmons WE. New-onset diabetes after transplantation (NODAT): an evaluation of definitions in clinical trials. Transplantation. 2013; 96 (1): 58-64.

10. Aasebø W, Midtvedt K, Valderhaug TG, Leivestad T, Hartmann A, Reisaeter AV et al. Impaired glucose homeostasis in renal transplant recipients receiving basiliximab. Nephrol Dial Transplant. 2010; 25 (4): 1289-1293.

11. Osorio JM, Bravo J, Pérez A, Ferreyra C, Osuna A. Magnesemia in renal transplant recipients: relation with immunosuppression and posttransplant diabetes. Transplant Proc. 2010; 42 (8): 2910-2913.

12. Hecking M, Haidinger M, Döller D, Werzowa J, Tura A, Zhang J et al. Early basal insulin therapy decreases new-onset diabetes after renal transplantation. J Am Soc Nephrol. 2012; 23 (4): 739-749.

13. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2007; 30 Suppl 1: S42-S47.

14. Palepu S, Prasad GV. New-onset diabetes mellitus after kidney transplantation: Current status and future directions. World J Diabetes. 2015; 6 (3): 445-455.