Risk Factors in and Long-Term Survival of Patients with Post-Transplantation Diabetes Mellitus: A Retrospective Cohort Study
| Autor: | Jun-Peng Chen, Yu-Chi Hou, Ming-Ju Wu, Ying-Mei Liu, Cheng-Hsu Chen, Ming-Fen Wu, Ching-Yao Cheng, Hue-Yu Wang |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
survival rate medicine.medical_specialty immunosuppressant Health Toxicology and Mutagenesis 030232 urology & nephrology Taiwan lcsh:Medicine 030230 surgery Article 03 medical and health sciences 0302 clinical medicine Postoperative Complications Risk Factors Internal medicine Diabetes mellitus medicine Diabetes Mellitus Humans Risk factor Survival rate Aged Retrospective Studies business.industry Incidence (epidemiology) lcsh:R Graft Survival Public Health Environmental and Occupational Health Retrospective cohort study Organ Transplantation Middle Aged medicine.disease Tacrolimus Calcineurin Transplantation post-transplant diabetes mellitus surgical procedures operative risk factor Female business Immunosuppressive Agents |
| Zdroj: | International Journal of Environmental Research and Public Health Volume 17 Issue 12 International Journal of Environmental Research and Public Health, Vol 17, Iss 4581, p 4581 (2020) |
| ISSN: | 1660-4601 |
| DOI: | 10.3390/ijerph17124581 |
| Popis: | Post-transplant diabetes mellitus (PTDM) is associated with infection, cardiovascular morbidity, and mortality. A retrospective cohort study involving patients who underwent renal transplantation in a transplantation center in Taiwan from January 2000 to December 2018 was conducted to investigate the incidence and risk factors of PTDM and long-term patient and graft survival rates. High age (45&ndash 65 vs. < 45 years, adjusted odds ratio (aOR) = 2.90, 95% confidence interval (CI) = 1.64&ndash 5.13, p < 0.001), high body mass index (> 27 vs. < 24 kg/m2, aOR = 5.35, 95% CI = 2.75&ndash 10.42, p < 0.001), and deceased organ donor (cadaveric vs. living, aOR = 2.01, 95% CI = 1.03&ndash 3.93, p = 0.04) were the three most important risk factors for the development of PTDM. The cumulative survival rate of patients and allografts was higher in patients without PTDM than in those with PTDM (p = 0.007 and 0.041, respectively). Concurrent use of calcineurin inhibitors and mammalian target of rapamycin inhibitors (mTORis) decreased the risk of PTDM (tacrolimus vs. tacrolimus with mTORi, aOR = 0.28, 95% CI = 0.14&ndash 0.55, p < 0.001). Investigating PTDM risk factors before and modifying immunosuppressant regimens after transplantation may effectively prevent PTDM development. |
| Databáze: | OpenAIRE |
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