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Guthoff, M. ; Wagner, R. ; Weichbrodt, K.* ; Nadalin, S.* ; Koenigsrainer, A.* ; Häring, H.-U. ; Fritsche, A. ; Heyne, N.

Dynamics of glucose metabolism after Kkdney transplantation.

Kidney Blood Press. Res. 42, 598-607 (2017)
Verlagsversion DOI PMC
Open Access Gold
Creative Commons Lizenzvertrag
Background/Aims: Posttransplantation diabetes mellitus (PTDM) impacts patient and allograft survival after kidney transplantation. Prediabetes, which is an independent risk factor for PTDM, is modifiable also in a post-transplant setting. Understanding the risks and dynamics of impaired glucose metabolism after transplantation is a key component for targeted intervention. Methods: A retrospective chart analysis of all adult non-diabetic renal allograft recipients (n=251, 2007-2014) was performed. Longitudinal follow-up included fasting plasma glucose and HbA1c, as well as data on allograft function and immunosuppression at consecutive time points (months 3-6 to >5 years post transplantation). Results: Throughout follow-up, median prevalence of prediabetes and PTDM was 53.3 [52.4-55.7]% and 15.4 [15.0-16.5]%, respectively. Continuously high fluxes between states of glucose metabolism, with individual patients' state deteriorating or improving over time, resulted in a high number of incident patients even long after transplantation. The greatest number of patients shifted between normal glucose tolerance and prediabetes, followed by those between prediabetes and PTDM. Conclusion: Prediabetes and PTDM are highly prevalent after kidney transplantation and incidences remain relevant throughout follow-up. Patient fluxes into and out of the prediabetic state show that glucose metabolism is highly dynamic after transplantation. This provides a continuous opportunity for intervention in an aim to reduce diabetes-associated complications.
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Publikationstyp Artikel: Journalartikel
Dokumenttyp Wissenschaftlicher Artikel
Korrespondenzautor
Schlagwörter Kidney Transplantation ; Posttransplantation Diabetes Mellitus ; Prediabetes ; Incidence ; Dynamics ; Risk Factors; Posttransplantation Diabetes-mellitus; Renal-transplantation; Risk-factors; Glycated Hemoglobin; Insulin-resistance; Steroid Withdrawal; Patient Survival; Fasting Glucose; Recipients; Tacrolimus
ISSN (print) / ISBN 1420-4096
e-ISSN 1423-0143
Zeitschrift Kidney & Blood Pressure Research
Quellenangaben Band: 42, Heft: 3, Seiten: 598-607 Artikelnummer: , Supplement: ,
Verlag Karger
Verlagsort Basel
Nichtpatentliteratur Publikationen
Begutachtungsstatus Peer reviewed
Institut(e) Institute of Diabetes Research and Metabolic Diseases (IDM)