沙希德·哈希米内贾德医院肾移植受者的移植后糖尿病

Posttransplant diabetes mellitus in kidney allograft recipients at Shaheed Hasheminejad Hospital.

作者信息

Savaj Shokoufeh, Abdi Ezatolah, Nejadgashti Hossein, Eris Sasan, Prooshaninia Fereidoun, Ataipoor Yosef, Ossareh Shahrzad, Abbasi Mohammad-Amin, Heidari Hora, Saheb-Jamii Hamid, Ebrahimzadeh Kaveh, Ghods Ahad J

机构信息

Department of Kidney Transplantation, Shaheed Hasheminejad Hospital, Iran University of Medical Sciences, Tehran, Iran.

出版信息

Iran J Kidney Dis. 2008 Jan;2(1):46-9.

DOI:

PMID:19367009

Abstract

INTRODUCTION

Our aim was to evaluate the frequency and risk factors of posttransplant diabetes mellitus (PTDM) at our kidney transplant center, and to compare graft and patient outcomes between the kidney recipients with and without PTDM.

MATERIALS AND METHODS

We studied 203 kidney transplant recipients with a negative history of diabetes mellitus before transplantation. We examined them for PTDM and made diagnosis on the basis of the American Diabetes Association criteria. Measurements of plasma glucose were carried out from 3 months to 24 months after transplantation. All data including recipient and donor demographics, cause of end-stage renal disease, cytomegalovirus and hepatitis C virus antibody tests, and patient and graft outcomes were assessed in relation to PTDM.

RESULTS

High fasting plasma glucose was seen in 24 (11.8%), 19 (9.4%), 16 (7.9%), and 13 (6.4%) patients at 3, 6, 12, and 24 posttransplant months, respectively. Moreover, impaired glucose tolerance was seen in 17 (8.4%), 16 (7.9%), 17 (8.4%), and 19 (9.4%) patients at the corresponding times, respectively. Accordingly, 39 patients (19.2%) were diagnosed to have PTDM. The mean age of the kidney recipients with PTDM was 46.5 +/- 12.3 years as compared to 38.6 +/- 13.4 years in nondiabetic kidney recipients (P = .02). The 5-year patient and graft survival rates were not significantly different between the kidney recipients with and without PTDM.

CONCLUSIONS

This study showed that PTDM is a common metabolic disorder in our kidney transplant patients. We recommend a less diabetogenic immunosuppressive protocol, especially for our older recipients.

摘要

引言

我们的目的是评估我们肾脏移植中心移植后糖尿病（PTDM）的发生率和危险因素，并比较有和没有PTDM的肾脏移植受者的移植物和患者结局。

材料与方法

我们研究了203例移植前无糖尿病病史的肾脏移植受者。我们对他们进行了PTDM检查，并根据美国糖尿病协会标准进行诊断。在移植后3个月至24个月进行血浆葡萄糖测量。所有数据，包括受者和供者的人口统计学资料、终末期肾病病因、巨细胞病毒和丙型肝炎病毒抗体检测以及患者和移植物结局，均与PTDM相关进行评估。

结果

移植后3、6、12和24个月时，分别有24例（11.8%）、19例（9.4%）、16例（7.9%）和13例（6.4%）患者空腹血糖升高。此外，相应时间分别有17例（8.4%）、16例（7.9%）、17例（8.4%）和19例（9.4%）患者糖耐量受损。因此，39例患者（19.2%）被诊断为患有PTDM。患有PTDM的肾脏移植受者的平均年龄为46.5±12.3岁，而无糖尿病的肾脏移植受者为38.6±13.4岁（P = 0.02）。有和没有PTDM的肾脏移植受者的5年患者和移植物存活率没有显著差异。