Lim Lee-Moay, Chang Jer-Ming, Kuo Hung-Tien
Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
Biomedicines. 2023 Feb 6;11(2):470. doi: 10.3390/biomedicines11020470.
Kidney transplant recipients are a unique subgroup of chronic kidney disease patients due to their single functioning kidney, immunosuppressive agent usage, and long-term complications related to transplantation. Post-transplant diabetes mellitus (PTDM) has a significant adverse effect on renal outcomes in particular. As transplantations enable people to live longer, cardiovascular morbidity and mortality become more prevalent, and PTDM is a key risk factor for these complications. Although PTDM results from similar risk factors to those of type 2 diabetes, the conditions differ in their pathophysiology and clinical features. Transplantation itself is a risk factor for diabetes due to chronic exposure to immunosuppressive agents. Considering current evidence, this article describes the risk factors, pathogenesis, diagnostic criteria, prevention strategies, and management of PTDM. The therapeutic options are discussed regarding their safety and potential drug-drug interactions with immunosuppressive agents.
肾移植受者是慢性肾脏病患者中的一个独特亚组,这是由于他们仅有一个功能正常的肾脏、使用免疫抑制剂以及存在与移植相关的长期并发症。移植后糖尿病(PTDM)尤其会对肾脏预后产生重大不良影响。随着移植使人们寿命延长,心血管发病率和死亡率变得更为普遍,而PTDM是这些并发症的一个关键危险因素。尽管PTDM与2型糖尿病的危险因素相似,但其病理生理学和临床特征有所不同。由于长期接触免疫抑制剂,移植本身就是糖尿病的一个危险因素。基于当前证据,本文描述了PTDM的危险因素、发病机制、诊断标准、预防策略及管理。还讨论了治疗选择的安全性以及它们与免疫抑制剂之间潜在的药物相互作用。