Almardini Reham, Salaita Ghazi, Albderat Jawaher, Alrabadi Katiba, Alhadidi Aghadir, Alfarah Mahdi, Abu Ruqa'a Ala', Dahabreh Dina
From the Pediatric/Pediatric Nephrology Departments, Queen Rania Abdullah Children Hospital, Amman, Jordan.
Exp Clin Transplant. 2019 Apr;17(2):165-169. doi: 10.6002/ect.2017.0328. Epub 2018 Jun 1.
Kidney transplant is the best renal replacement therapy for pediatric patients with end-stage renal disease; however, this procedure is not without complications. A major complication is the development of new-onset diabetes mellitus, which affects the outcomes of transplant in terms of kidney and patient survival. In this study, our objective was to calculate the percentage of pediatric patients who developed new-onset diabetes mellitus or transient hyperglycemia after kidney transplant, compare our data with international data, and discuss the related factors that predispose to diabetes.
A retrospective study was conducted by reviewing the medical records of pediatric patients who had transplant procedures or were followed at the Royal Medical Services (Amman, Jordan) from 2007 to 2017.
Our study cohort included 104 patients. The average follow-up time was 4 years and 7 months, with a maximum follow-up of 9 years. Ten patients developed posttransplant hyperglycemia, with 8 developing early hyperglycemia (during the first 3 months posttransplant). In 40% of patients, this complication was transient, and patients stopped insulin after immunosuppressant medications were decreased. However, 60% of patients continued to have diabetes, with 20% having late-onset diabetes and treatment with oral hypoglycemic agent.
Pretransplant awareness of risk factors of new-onset diabetes mellitus after transplant and close monitoring of hyperglycemia during the posttransplant period are mandatory. Transient hyperglycemia after kidney transplant is common, and kidney transplant does not alleviate the high risk of diabetes in patients with chronic kidney disease.
肾移植是终末期肾病患儿最佳的肾脏替代治疗方法；然而，该手术并非没有并发症。一个主要并发症是新发糖尿病的发生，这在肾脏和患者存活方面会影响移植结果。在本研究中，我们的目的是计算肾移植后发生新发糖尿病或短暂性高血糖的儿科患者百分比，将我们的数据与国际数据进行比较，并讨论易患糖尿病的相关因素。
通过回顾2007年至2017年在皇家医疗服务机构（约旦安曼）接受移植手术或接受随访的儿科患者的病历进行回顾性研究。
我们的研究队列包括104名患者。平均随访时间为4年7个月，最长随访时间为9年。10名患者发生移植后高血糖，其中8名发生早期高血糖（移植后前3个月内）。40%的患者该并发症为短暂性，在免疫抑制剂药物减量后患者停用胰岛素。然而，60%的患者继续患有糖尿病，20%患有迟发性糖尿病并接受口服降糖药治疗。
移植前了解移植后新发糖尿病的危险因素并在移植后密切监测高血糖是必不可少的。肾移植后短暂性高血糖很常见，肾移植并不能减轻慢性肾病患者患糖尿病的高风险。
