Nephrology Department, Antonios B. Billis, General Hospital of Euaggelismos, Athens, Greece.
First Department of Internal Medicine, University Hospital of Alexandroupolis, Democritus University of Thrace (DUTH), Alexandroupolis, Greece.
Transplant Proc. 2021 Nov;53(9):2782-2785. doi: 10.1016/j.transproceed.2021.09.001. Epub 2021 Oct 21.
The occurrence of diabetes mellitus is common after kidney transplantation (posttransplant diabetes mellitus [PTDM]) and enhances the cardiovascular risk and risk for kidney graft loss. The incidence of PTDM is about 5% to 40%. This study aimed to examine the potential risk factors that determine the occurrence of PTDM.
This study retrospectively included 298 patients from transplantation unit of Evangelismos who underwent kidney transplantation during a 10-year period (January 1, 2009, to January 1, 2019). Kidney transplant recipients with diabetes mellitus prior to transplantation or those with follow-up of <6 months were rejected from the study. In total, the study included 274 recipients with a mean age of 50 ± 18 years. The mean time of monitoring was 63 ± 18 months. The PTDM diagnosis was based on the 2018 criteria of the American Diabetes Association.
Of 274 kidney transplant recipients, PTDM developed in 38 (13.8%) patients over a period of 11 ± 9 months after transplantation. Given that immunosuppressive therapy was identical in most patients, statistical analysis did not correlate the incidence of diabetes with treatment. However, there was a correlation for the occurrence of PTDM between the presence of hypomagnesemia and increased uric acid levels. Finally, there was a negative correlation between the age of the recipient and the time of PTDM onset.
Hypomagnesemia and hyperuricemia increased the risk of PTDM in these patients. Given the association between hypomagnesemia and the development of diabetes mellitus after kidney transplantation, prospective studies are needed to identify the causes of PTDM and to develop prevention strategies.
糖尿病在肾移植后很常见（移植后糖尿病[PTDM]），会增加心血管风险和肾移植物丢失的风险。PTDM 的发病率约为 5%至 40%。本研究旨在探讨确定 PTDM 发生的潜在危险因素。
本研究回顾性纳入了 2009 年 1 月 1 日至 2019 年 1 月 1 日期间在 Evangelismos 移植科接受肾移植的 298 例患者。排除了移植前患有糖尿病或随访时间<6 个月的患者。共纳入 274 例年龄 50±18 岁的肾移植受者。监测的平均时间为 63±18 个月。PTDM 的诊断依据是美国糖尿病协会 2018 年的标准。
在 274 例肾移植受者中，38 例（13.8%）患者在移植后 11±9 个月内发生 PTDM。由于大多数患者的免疫抑制治疗相同，因此统计分析并未将糖尿病的发病率与治疗相关联。然而，低镁血症和尿酸水平升高与 PTDM 的发生存在相关性。最后，受者年龄与 PTDM 发病时间呈负相关。
低镁血症和高尿酸血症增加了这些患者发生 PTDM 的风险。鉴于低镁血症与肾移植后糖尿病的发生之间存在关联，需要开展前瞻性研究以确定 PTDM 的病因并制定预防策略。
