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MO952: Risk Factors of Post Transplantation Diabetes Mellitus After Kidney Transplantation


 
 
 Between 10 and 30% of kidney transplant recipients develop post-transplant diabetes mellitus (PTDM). PTDM is a major risk factor for cardiovascular events and death in kidney transplant recipients. At our center prednisolone doses are tapered to a low maintenance dose eight weeks after transplantation. In a retrospective single-center cohort study, we investigated risk factors for development of de novo PTDM from 8 weeks after kidney transplantation.
 
 
 
 Inclusion criteria were kidney transplantation, age > 18 years, no known diabetes prior to, or at the 8-week control after transplantation and with at least one year of follow up. At the 8-week control an oral glucose tolerance test (OGTT) was performed for PTDM diagnosis. De novo PTDM was defined as fasting glucose ≥7 mmol/L, 2-h glucose ≥11.1 mmol/L at OGTT performed routinely at the one-year visit, or at least two registered dispensations of glucose lowering medication in the Norwegian Prescription Database (NorPD).
 
 
 
 In total 632 patients (median age 53 years, 62% males) with a median follow-up of 2.7 years [1–4] were included of which 54 (8.5%) developed de novo PTDM (31 diagnosed by the OGTT at 1 year and 23 identified by glucose lowering dispensation). De novo PTDM patients were older than non-PTDM patients at transplantation (median age 63 versus 52 years), were more often males (81% versus 61%), and had higher fasting blood glucose (mean 5.8 versus 5.3 mmol/L), 2-h glucose (mean 8.3 versus 6.6 mmol/L) and HbA1c (median 38 versus 32 mmol/mol) at the 8-week post-transplantation control.
 In a multiple logistic regression analysis, significant associated factors of PTDM were age (years), OR 1.04 (CI 95%: 1.01;1.06), triglycerides (mmol/L), OR 1.42 (CI 95%: 1.10;1.81) and tacrolimus (µg/L) OR 1.23 (CI 95%: 1.03;1.46) concentrations measured at the one-year control visits, and CMV serostatus (positive donor to negative recipient), OR 2.12 (CI 95%: 1.04;4.28). Plasma magnesium, gender, BMI and plasma creatinine were not associated with development of PTDM.
 
 
 
 Development of de novo PTDM from 8 weeks after kidney transplantation was associated with increased age, higher triglycerides, higher tacrolimus concentrations and D+/R- CMV-serostatus.
