Post-transplantation diabetes mellitus in patients with kidney allotransplantation
DOI: https://dx.doi.org/10.18565/nephrology.2018.4.20-24
M.S. Novikova, S.S. Allazova, O.N. Kotenko, Е.М. Shilov
1 SBHCI "Endocrinological Dispensary of the Moscow Healthcare Department"; Moscow, Russia;
2 FSAEI HE "I.M. Sechenov First Moscow State Medical University" of the Ministry of Health of the Russian Federation; Moscow, Russia;
3 SBHCI "City Clinical Hospital № 52 of the Moscow Healthcare Department DZM"; Moscow, Russia;
4 FSAEI HE "Peoples' Friendship University of Russia"; Moscow, Russia
Objective. To identify the prevalence and risk factors for the development of post-transplantation diabetes mellitus (PTDM) after kidney allotransplantation (KAT).
Material and methods. A retrospective analysis of out-patient medical records of 146 kidney allograft recipients, obtained from 1989 to 2014, was performed. The diagnosis of diabetes mellitus established before the KAT was used as the exclusion criterion for participation in the study. As risk factors, gender, age, KAT duration and the use of glucocorticosteroids (GCS), tacrolimus (Tc), and cyclosporin A (CsA) were analyzed; their significance was assessed using stepwise linear regression analysis.
Results. The mean age of the recipients at the time of the study was 42.9±20.2 (years. The prevalence of PTDM in the general group was 21.9% (n=32). Age (P=0.01), the use of CsA and GCSs, the timing of ATP (P=0.01) and the mode of immunosuppressive therapy (P=0.01) had the greatest influence on the development of PTDM. After the conversion of CsA to Tc, the prevalence of PTDM has increased from 11 (18.6%) to 21 (26%) cases.
Conclusion. PTDM was diagnosed in 1/5 of the recipients of the kidney transplant. It was revealed that older patients have a greater risk of developing PTDM than younger recipients. Along with age, the use of immunosuppressive therapy with calcineurin inhibitors in combination with GCSs significantly increases the risk of developing PTDM.
Keywords: post-transplantation diabetes mellitus, kidney allotransplantation, calcineurin inhibitors, tacrolimus, cisclosporin A, glucocorticosteroids
About the Autors
Novikova M.S. – PhD in Medical Sciences, Nephrologist, SBHCI "Endocrinological Dispensary of the Moscow Healthcare Department"; Moscow, Russia. E-mail: citrus7474@mail.ru
Allazova S.S. – Postgraduate Student at the Department of Internal, Occupational Diseases and Rheumatology, FSAEI HE "I.M. Sechenov First MSMU" of the Ministry of Health of the Russian Federation; Moscow, Russia. Е-mail: tallisasoto@rambler.ru
Kotenko O.N. – PhD in Medical Sciences, Chief Freelance Specialist-Nephrologist of the Moscow Healthcare Department, Deputy Chief Physician for Nephrological Care SBHCI "CCH № 52 of the Moscow Healthcare Department", Associate Professor at the Department of Hospital Therapy with a Course of Hematology FSAEI HE PFUR; Moscow, Russia.
Е-mail: info@gkb52.mosgorzdrav.ru
Shilov E.M. – Doctor of Medical Sciences, Professor at the Department of Internal, Occupational Diseases and Rheumatology, FSAEI HE "I.M. Sechenov First MSMU" of the Ministry of Health of the Russian Federation; Moscow, Russia. E-mail: emshilov@mma.ru