NEW-ONSET DIABETES MELLITUS AFTER KIDNEY TRANSPLANTATION: SINGLE CENTER EXPERIENCE

New-onset diabetes mellitus  after  transplantation (NODAT) in kidney  transplant recipients promote the development of complications and  have  a negative impact on kidney  transplantation (KT) results.

Aim. Comparison of clinico-demographic characteristics and  KT results in recipients with and  without  NODAT.

Patients and methods.  Study included 439  patients 18+ years without  pre-transplantation diabetes who  underwent KT from  the  deceased donor in our  center from  01.01.2007 to 31.12.2016. All patients after  KT received calcineurin inhibitors and  mycophenolate, 322 received tacrolimus (TAK), 117cyclosporin A (CsA). Seventeen recipients received immunosuppression without  steroids.

Results. NODAT developed in 41 (9.3%) of 439 patients: 33 (10.2%) of 322 on TAK, and  8 of 117 (6.8%) on CsA, p=0.368. The groups with NODAT and  without NODAT did not differ in gender, proportion of patients with polycystic kidney disease, modality and duration of dialysis, features of immunosuppression, although there was  a tendency for older  age and  higher body  mass index  in patients with NODAT. In NODAT group there were significantly more patients with preexisting metabolic syndrome (31.7% versus 12.3%, p = 0.002), post-transplant surgical complications (21.9% vs. 8.5%, p= 0.012), fungal  infections (14.6% vs 5.0%, p=0.026), cardiovascular  complications (26.8% vs. 9.8%, p=0.003), patients who  died  with functioning graft  (17.1% % vs. 5.5%, p = 0.0012). Recipients and  transplants survival was significantly lower in NODAT group (p=0.008, p=0.022, resp.).

Conclusion. NODAT negatively affects the results of KT. Prevention, early detection and adequate treatment of NODAT can reduce the incidence of complications after  KT and  improve recipients and  transplants survival.

kidney transplantation, immunosuppression, complications, new-onset diabetes after transplantation, risk factors

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