Comparison of risk factors for developing post-transplant diabetis mellitus in patients with kidney allograft


DOI: https://dx.doi.org/10.18565/nephrology.2020.1.39-43

S.S. Allazova, M.S. Novikova, O.N. Kotenko, E.M. Shilov

1) Sechenov First Moscow State Medical University, Moscow, Russia; 2) Endocrinological Dispensary of the Moscow Healthcare Department, Moscow, Russia; 3) City Clinical Hospital № 52 of the Moscow Healthcare Department, Moscow, Russia; 4) Peoples' Friendship University of Russia, Moscow, Russia
Objective. Comparison of the risk factors for the development of post-transplant diabetes mellitus (PTDM) in kidney allograft recipients in Moscow.
Material and methods. A cross-sectional study included 49 kidney allograft recipients with a previously established diagnosis of PTDM who lived more than a year after kidney allotransplantation (KAT) and were followed-up in the Moscow City Nephrology Center of the Moscow Healthcare Department. PTDM was diagnosed according to the World Health Organization and the American Diabetes Association (ADA) criteria.
Results. The mean age of kidney allograft recipients with and without PTDM at the time of KAT was 49.9±11.8 and 57.4±73 years, respectively. The diagnosis of PTDM was confirmed for 33 kidney allograft recipients according to the ADA 2003 criteria. In 16 kidney allograft recipients, the diagnosis of PTDM was revised due to normal glycosylated hemoglobin (НbА1с) and fasting glycemia levels and the absence of hypoglycemic therapy. We did not reveal any statistically significant differences between the two groups of kidney allograft recipients with and without PTDM, except for HbA1c (р=0.002) and fasting glycemia (р=0.03) levels. A correlation was found between ACR (albumin-creatinine ratio) and IR-HOMA (r=0.309; р=0.02), ACR and HOMA-β
(r= -0.278; р=0.036) in the general group of recipients. The same correlations are characteristic for a group of recipients without PTDM, but not for recipients with PTDM.
Conclusion. In the group with PTDM, body mass index (р=0.06), glycemia levels (р=0.03) and HbA1c (р=0.002) level were higher than in the group of patients without PTDM. Correlations between ACR and IR-HOMA, HOMA-β were revealed in the group
of recipients without PTDM (r=0.792; р=0.000 and r=-0.524; р=0.027), but not for recipients with PTDM (r=0.235; р=0.105 and r=-0.264; р=0,083), who received antidiabetic therapy with drugs that reduce insulin resistance. Thus, mTOR (mammalian target of rapamycin) inhibitors were more often used in patients with PTDM, but without statistically significant differences between the groups (р>0.05).

About the Autors


Sona S. Allazova – Postgraduate Student at the Department of Internal Diseases, Occupational Diseases and Rheumatology, Sechenov First Moscow State Medical University; Moscow, Russia. E-mail: tallisasoto@rambler.ru, tel. +7 (926) 823-96-14.
Maria S. Novikova – PhD in Medical Sciences, Nephrologist, Endocrinological dispensary of the Moscow Healthcare Department; Moscow, Russia.
E-mail: citrus7474@mail.ru, tel. +7 (926) 226-22-92.
Oleg N. Kotenko – PhD in Medical Sciences, Chief Expert in Nephrology of the Moscow Healthcare Department, Deputy Chief Physician for Nephrological Care, City Clinical Hospital № 52 of the Moscow Healthcare Department; Moscow, Russia. E-mail: olkotencko@yandex.ru
Evgeny M. Shilov – Doctor of Medical Sciences, Professor at the Department of Internal Diseases, Occupational Diseases and Rheumatology, Sechenov First Moscow State Medical University; Moscow, Russia. E-mail: emshilov@mma.ru


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