New-onset diabetes mellitus after renal transplantation
Abstract
Aims
To determine: (i) the incidence of new-onset diabetes mellitus in patients after renal transplantation (NODM); and (ii) the association between NODM and (a) various immunosuppressive regimens, and (b) ethnicity; and (iii) to assess outcomes in terms of morbidity and mortality associated with NODM, i.e. infections, cardiovascular disease, graft function and survival, and overall patient survival.
Study design
A retrospective analysis of 398 patient files from Johannesburg Hospital for the transplant period 1 July 1994 to 30 June 2004 was conducted. Information regarding patient age, race, date of onset of diabetes, immunosuppressive regimen, infections, and ardiovascular and overall morbidity and mortality was recorded.
Results
Of the patients 15.6% became diabetic (62/398) with a mean time to onset of 22.9 months; 20.2% of black patients (p=0.100), 12.5% of coloured (mixed race) patients, 12.0% of Indian patients and 9.4% of white patients developed NODM. Treatment with cyclosporin A was associated with a 14.4% incidence of diabetes, tacrolimus with an incidence of 20.3% (p=0.228), sirolimus with an incidence of 11.4% and mycophenolate mofetil with an incidence of 12.0%. The patients with diabetes had an infection rate of 96.8% (p
To determine: (i) the incidence of new-onset diabetes mellitus in patients after renal transplantation (NODM); and (ii) the association between NODM and (a) various immunosuppressive regimens, and (b) ethnicity; and (iii) to assess outcomes in terms of morbidity and mortality associated with NODM, i.e. infections, cardiovascular disease, graft function and survival, and overall patient survival.
Study design
A retrospective analysis of 398 patient files from Johannesburg Hospital for the transplant period 1 July 1994 to 30 June 2004 was conducted. Information regarding patient age, race, date of onset of diabetes, immunosuppressive regimen, infections, and ardiovascular and overall morbidity and mortality was recorded.
Results
Of the patients 15.6% became diabetic (62/398) with a mean time to onset of 22.9 months; 20.2% of black patients (p=0.100), 12.5% of coloured (mixed race) patients, 12.0% of Indian patients and 9.4% of white patients developed NODM. Treatment with cyclosporin A was associated with a 14.4% incidence of diabetes, tacrolimus with an incidence of 20.3% (p=0.228), sirolimus with an incidence of 11.4% and mycophenolate mofetil with an incidence of 12.0%. The patients with diabetes had an infection rate of 96.8% (p