Trends and predictors of diabetes mellitus after living kidney transplantation: A retrospective study.

BACKGROUND

Post-transplant diabetes mellitus (PTDM) is a common metabolic adverse event following kidney transplantation, negatively impacting graft function and patient outcomes.

AIM

To evaluate the frequency of PTDM and to determine predictive factors in living donor individuals who have undergone kidney transplantation.

METHODS

A retrospective analysis was conducted on 1200 living donor kidney transplant recipients treated between 2016 and 2023. Demographic, clinical, and treatment data were collected, and PTDM was identified based on American Diabetes Association criteria. Statistical analysis included logistic regression analysis to determine independent predictors of PTDM.

RESULTS

PTDM was diagnosed in 162 patients (13.5%). Risk factors included older age [odds ratio (OR) 1.03, = 0.03], increased body mass index (OR 1.08, = 0.02), a genetic predisposition to diabetes (OR 1.95, = 0.001), and corticosteroid use (OR 1.30, = 0.04). Most PTDM cases (61.7%) occurred during the initial 6 months after transplant. Tacrolimus-based regimens were more commonly associated with PTDM compared to other protocols. Renal function at 12 months was comparable between PTDM and non-PTDM groups.

CONCLUSION

PTDM remains a significant concern in kidney transplantation, particularly among patients with modifiable risk factors. Optimizing immunosuppressive regimens, implementing early metabolic monitoring, and addressing modifiable risks such as BMI may help reduce PTDM incidence. Additional research is required to evaluate extended-term results and refine preventive strategies.