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Abstract: FR-PO817

Effectiveness of Metformin in Kidney Transplant Recipients With Post-Transplantation Diabetes Mellitus

Session Information

Category: Transplantation

  • 2002 Transplantation: Clinical

Authors

  • Lee, Dongyeon, Asan Medical Center, Songpa-gu, Seoul, Korea (the Republic of)
  • Jung, Jiyun, Data management and Statistics Institute, Dongguk University Ilsan Hospital, Goyang, Gyeonggi, Korea (the Republic of)
  • Lee, Jangwook, Research Center for Chronic Disease and Environmental Medicine, Dongguk University College of Medicine, Goyang, Gyeonggi, Korea (the Republic of)
  • Shin, Sung Joon, Research Center for Chronic Disease and Environmental Medicine, Dongguk University College of Medicine, Goyang, Gyeonggi, Korea (the Republic of)
  • Kim, Sichan, Asan Medical Center, Songpa-gu, Seoul, Korea (the Republic of)
  • Baek, Chung Hee, Asan Medical Center, Songpa-gu, Seoul, Korea (the Republic of)
  • Park, Su-Kil, Asan Medical Center, Songpa-gu, Seoul, Korea (the Republic of)
  • Park, Jae Yoon, Research Center for Chronic Disease and Environmental Medicine, Dongguk University College of Medicine, Goyang, Gyeonggi, Korea (the Republic of)
  • Kim, Hyosang, Asan Medical Center, Songpa-gu, Seoul, Korea (the Republic of)
Background

Post-transplantation diabetes mellitus (PTDM) is an important risk factor for cardiovascular disease and mortality. We aimed to determine the influence of metformin on cardiovascular and graft outcome in PTDM.

Methods

We included 618 kidney transplant recipients with new-onset PTDM in Asan Medical Center and Dongguk University Ilsan Hospital between 2000 and 2018. PTDM was defined as maintained hypoglycemic treatment, three months or more after transplantation. We conducted the propensity score matching (PSM) in metformin and non-metformin group by estimated Glomerular Filtration Rate (eGFR), sex, age, body mass index, and immunosuppressive agents. Cox proportional hazard models were also conducted to estimate the effects of the metformin usage compared to non-metformin on percutaneous coronary intervention (PCI), major adverse cardiovascular events (MACE), acute rejection (AR), and graft failure (GF).

Results

Before matching, 406 patients (66%) prescribed metformin, and the average eGFR (59.8 mL/min/1.73m2) and HbA1c (7.5%) in metformin group was higher than non-metformin group (53.3 mL/min/1.73m2 for eGFR; 7.2 % for HbA1c). After 1:1 matching in PSM, no group differences in eGFR and HbA1c were observed. In Kaplan-Meier plot, metformin usage was associated with higher survival probability on PCI (p=0.01) and GF (p=0.03). In Cox proportional hazard model, metformin usage was associated with lower risk of PCI (hazard ratio [HR]: 0.31; 95% confidence interval [CI]: 0.11–0.86; p=0.02). In addition, compared with the non-metformin group, the HR of the long-term use of metformin (≥1664 days, median value) was 0.21 (95% CI 0.06–0.70; p=0.01).

Conclusion

This study demonstrates that the use of metformin was associated with a decreased risk of coronary artery disease in kidney transplant recipients with PTDM. Metformin would be considered as one of feasible treatment options for PTDM.