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Kidney Week

Abstract: TH-PO153

Cardiovascular Events After Kidney Transplantation: Seven-Year Follow-Up of the Vienna Treat-to-Target Trial of Basal Insulin in Post-Transplant Hyperglycemia (TIP)

Session Information

Category: Transplantation

  • 1802 Transplantation: Clinical

Authors

  • Hecking, Manfred, Medical University of Vienna, Nephrology & Dialysis, Vienna, Austria
  • Topitz, David, Medical University of Vienna, Vienna, Austria
  • Saemann, Marcus D., Wilhelminen Hospital, Vienna, Austria
Background

In our previous proof-of-concept clinical trial, basal insulin therapy early after kidney transplantation significantly reduced the odds of posttransplant diabetes mellitus (PTDM) throughout 1 year of follow-up (PMID22343119). We investigated whether the occurrence of cardiovascular events (CVEs) differed by insulin therapy, respectively by oral glucose tolerance test (OGTT)-derived glycemic status.

Methods

We obtained ethics approval for following up on the Vienna TIP-study patients, in order to compare CVEs in those who had received insulin versus standard of care control treatment; and in patients with normal glucose tolerance (NGT, 2-hour glucose [2-h G] <140 mg/dL), versus in prediabetics (2-h G 140-199) plus diabetics (2-h G ≥200), per OGTT-result at 3, 6 and 12 months posttransplantation.

Results

Seven of the original 50 TIP-study patients were lost to follow-up. Occurrence of CVEs differed by diabetic status, but not by treatment status (Figure). None of the patients with NGT experienced any CVE, but NGT patients were significantly younger (Table).

Conclusion

The present results lead to the hypothesis that PTDM might be a read-out for older, potentially sicker patients, and that CVE occurrence might not be modifiable by antidiabetic treatment.