Journal Article

The increased risk of post-transplant diabetes mellitus in peritoneal dialysis-treated kidney allograft recipients

Katarzyna Madziarska, Waclaw Weyde, Magdalena Krajewska, Dariusz Patrzalek, Dariusz Janczak, Mariusz Kusztal, Hanna Augustyniak-Bartosik, Przemyslaw Szyber, Cyprian Kozyra and Marian Klinger

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 26, issue 4, pages 1396-1401
Published in print April 2011 | ISSN: 0931-0509
Published online September 2010 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/gfq568
The increased risk of post-transplant diabetes mellitus in peritoneal dialysis-treated kidney allograft recipients

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Background. Post-transplant diabetes mellitus (PTDM) is a common metabolic complication in kidney allograft recipients, significantly contributing to the elevated cardiovascular morbidity after renal transplantation and increased risk of chronic transplant dysfunction. The aim of the present investigation was to evaluate the factors influencing PTDM development. Under particular consideration were the elements, existing before the transplantation, especially the modality of dialysis treatment significance, i.e. haemodialysis (HD) versus peritoneal dialysis (PD).

Methods. Three hundred and seventy-seven consecutive outpatients who underwent renal transplantation (RTx) in our institution between January 2003 and December 2005 were analysed. PTDM was diagnosed according to the current American Diabetic Association/World Health Organization criteria. Statistical inference was conducted by means of univariate methods (one factor versus PTDM) and multivariate methods in frames of generalized linear model.

Results. In the study group, 72 patients (23.4%) developed PTDM after RTx (55 HD and 17 PD patients). PTDM incidence at 3, 6 and 12 months was 15.9%, 22.1% and 23.4%, respectively. The mean interval from transplantation to the onset of PTDM was 3.08 ± 2.73 months. In univariate analysis, the factors associated with the elevated risk of PTDM appearance were older recipient age, positive family history of diabetes, hypertensive nephropathy as end-stage renal disease cause, higher body mass index at transplantation, treatment by PD, and the graft from an older donor. In multivariate verification, statistical significance remained: older recipient age (P < 0.001), positive family history of diabetes (P = 0.002), and treatment by PD (P = 0.007).

Conclusions. Treatment by PD appears to be a possible novel factor, not yet reported, which may increase the risk of PTDM development.

Keywords: modality of dialysis treatment; peritoneal dialysis versus haemodialysis; post-transplant diabetes mellitus; pre-transplant risk factors

Journal Article.  2754 words.  Illustrated.

Subjects: Nephrology

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