Effect of Early Steroid Withdrawal on Posttransplant Diabetes Among Kidney Transplant Recipients Differs by Recipient Age.
Autor: | Ahn JB; Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD., Bae S; Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD., Schnitzler M; Center for Abdominal Transplantation, Saint Louis University School of Medicine, St. Louis, MO., Hess GP; Department of Emergency Medicine, Drexel University College of Medicine, Philadelphia, PA., Lentine KL; Center for Abdominal Transplantation, Saint Louis University School of Medicine, St. Louis, MO., Segev DL; Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD., McAdams-DeMarco MA; Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. |
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Jazyk: | angličtina |
Zdroj: | Transplantation direct [Transplant Direct] 2021 Dec 13; Vol. 8 (1), pp. e1260. Date of Electronic Publication: 2021 Dec 13 (Print Publication: 2022). |
DOI: | 10.1097/TXD.0000000000001260 |
Abstrakt: | Background: Posttransplant diabetes (PTD), a major complication after kidney transplantation (KT), is often attributable to immunosuppression. The risk of PTD may increase with more potent steroid maintenance and older recipient age. Methods: Using United States Renal Data System data, we studied 12 488 adult first-time KT recipients (2010-2015) with no known pre-KT diabetes. We compared the risk of PTD among recipients who underwent early steroid withdrawal (ESW) versus continued steroid maintenance (CSM) using Cox regression with inverse probability weighting to adjust for confounding. We tested whether the risk of PTD resulting from ESW differed by recipient age (18-29, 30-54, and ≥55 y). Results: Of 12 488, 28.3% recipients received ESW. The incidence rate for PTD was 13 per 100 person-y and lower among recipients who received ESW (11 per 100 person-y in ESW; 14 per 100 person-y in CSM). Overall, ESW was associated with lower risk of PTD compared with CSM (adjusted hazard ratio [aHR] = Conclusions: The beneficial association of ESW with decreased PTD was more pronounced among recipients aged ≥55, supporting an age-specific assessment of the risk-benefit balance regarding ESW. Competing Interests: D.L.S. receives speaking honoraria from Sanofi and Novartis. The other authors declare no conflicts of interest. (Copyright © 2021 The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc.) |
Databáze: | MEDLINE |
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