Lima Camila, Grden Amanda, Skare Thelma, Jaworski Paulo, Nisihara Renato
Universidade Evangélica, Departamento de Medicina, Curitiba, PR, Brasil.
Universidade Positivo, Departamento de Medicina, Curitiba, PR, Brasil.
Arch Endocrinol Metab. 2018;62(6):597-601. doi: 10.20945/2359-3997000000084.
This study aims to verify the new-onset diabetes after kidney transplant (NODAT) incidence in recipients within 1 year after kidney transplantation from a single center in Southern Brazil and to assess the associated conditions.
A retrospective study of 258 post-renal transplant patients was performed. Demographic (gender, age, ethnic background) and clinical (origin of graft, associated infections, body mass index (BMI) at transplant time and 6 and 12 months after, causes of renal failure, and comorbidities) data were analyzed. All patients were on tacrolimus, mycophenolate mofetil, and prednisone treatment. Patients with and without NODAT were compared.
A NODAT incidence of 31.2% was noted 1 year post transplantation. In the univariate analysis, patients with NODAT were older (p = 0.001), mostly had African-American ethnic background (p = 0.02), and had renal failure secondary to high blood pressure (HBP) (p = 0.001). The group of patients with NODAT also had more incidence of post-transplant HBP (p = 0.01), heart failure (p = 0.02), and dyslipidemia (p = 0.001). Logistic regression showed that African-American ethnic background, post-transplant HBP, and dyslipidemia were independently associated with NODAT.
This study shows a NODAT incidence that is greater in patients with African-American ethnic background and that is associated with HBP and dyslipidemia.
本研究旨在核实巴西南部单一中心肾移植受者在肾移植后1年内新发糖尿病(NODAT)的发病率,并评估相关情况。
对258例肾移植术后患者进行回顾性研究。分析了人口统计学数据(性别、年龄、种族背景)和临床数据(移植物来源、相关感染、移植时以及移植后6个月和12个月时的体重指数(BMI)、肾衰竭原因和合并症)。所有患者均接受他克莫司、霉酚酸酯和泼尼松治疗。对发生和未发生NODAT的患者进行比较。
移植后1年时NODAT发病率为31.2%。单因素分析显示,发生NODAT的患者年龄较大(p = 0.001),大多具有非裔美国人种族背景(p = 0.02),且继发于高血压(HBP)的肾衰竭发生率较高(p = 0.001)。发生NODAT的患者组移植后HBP、心力衰竭和血脂异常的发生率也更高(p分别为0.01、0.02和0.001)。逻辑回归分析显示,非裔美国人种族背景、移植后HBP和血脂异常与NODAT独立相关。
本研究表明,具有非裔美国人种族背景的患者NODAT发病率更高,且与HBP和血脂异常有关。