Kidney Week

Abstract: FR-PO840

Retrospective Evaluation of the Prevalence of Diabetes Mellitus in a Single Center Renal Transplant Cohort

Session Information

• Transplantation: Clinical - Outcomes
  November 04, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 2002 Transplantation: Clinical

Authors

• Alfieri, Carlo, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Lombardia, Italy

Carlo Alfieri,

• Cicero, Elisa, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Lombardia, Italy

Elisa Cicero,

• Molinari, Paolo, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Lombardia, Italy

Paolo Molinari,

• Cresseri, Donata Carmela, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Lombardia, Italy

Donata Carmela Cresseri,

• Regalia, Anna, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Lombardia, Italy

Anna Regalia,

• Campise, Mariarosaria, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Lombardia, Italy

Mariarosaria Campise,

• Gandolfo, Maria Teresa, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Lombardia, Italy

Maria Teresa Gandolfo,

• Favi, Evaldo, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Lombardia, Italy

Evaldo Favi,

• Castellano, Giuseppe., Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Lombardia, Italy

Giuseppe. Castellano,

Background

Novel onset of diabetes after transplantation (NODAT) might impact significantly in renal transplant (RTx) and RTx patients (RTxps) outcome. In this study we evaluated: 1) the prevalence of diabetic patients who access the RTx 2) the incidence of NODAT and 3) the most related factors for the development of diabetes after RTx.

Methods

We retrospectively studied 522 RTxps transplanted in our Unit between January 2004 and December 2014. Each patient underwent: 1) to a collection of remote and pathological anamnesis and complete physical examination and to routine and specific clinical and biochemical determinations at 1 (T1), 6 (T6) and 12 (T12) months after RTx. At six months of RTx, the Oral Glucose Tolerance Test (OGTT) was performed.

Results

The age of RTxps was 48±12 years. Patients with glucose metabolism abnormalities were significantly older, without differences in gender. In patients with NODAT (12.6%), cyclosporine was used more than tacrolimus, and higher doses of steroids at T1 and T6 were prescribed. They had a worse general metabolic and glucose (HOMA index, glycaemia and HbA1c) status than normoglycemic. Of note, no differences in 25-(OH)-D and in the other mineral metabolism parameters were found. In multivariate analysis, we found that age at transplant (OR 1.28 for 5 years older) (p = 0.006), BMI at T1 (OR 1.22 for 2 kg / m² more) (p = 0.01) and the dose of steroid prescribed during the first post RTx month (OR 2.7 per 100 mg additional drug) (p = 0.03) were independently correlated with NODAT.

Conclusion

In this study, we demonstrated that the prevalence of NODAT was relatively high in our cohort reflecting data present in the literature. Interestingly, age at RTx, BMI and cumulative dose of steroids resulted the variables that significantly and strongly influence its development. On the other hand, no relationship was observed between blood values of vitamin D, parathormone and the onset of NODAT. Future research, possibly involving a higher number of RTxps could also evaluate the effects of NODAT on graft and patients on long term outcome.