Associations Between Posttransplantation Diabetes Mellitus and Renal Graft Survival
| Autor: | Thea Anine Strøm Halden, Trond Jenssen, Anders Åsberg, Dag Olav Dahle, Ivar Eide, Anders Hartmann |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Blood Glucose Graft Rejection Male medicine.medical_specialty Time Factors Treatment outcome 030232 urology & nephrology Renal graft Kaplan-Meier Estimate 030230 surgery urologic and male genital diseases Risk Assessment 03 medical and health sciences 0302 clinical medicine Risk Factors Diabetes mellitus Internal medicine Diabetes Mellitus medicine Humans Aged Proportional Hazards Models Retrospective Studies Transplantation Norway business.industry Proportional hazards model Graft Survival Retrospective cohort study Middle Aged medicine.disease Kidney Transplantation Surgery Treatment Outcome surgical procedures operative Renal transplant Acute Disease Female Graft survival business Biomarkers |
| Zdroj: | Transplantation. 101:1282-1289 |
| ISSN: | 0041-1337 |
| Popis: | Previous reports indicate that posttransplantation diabetes mellitus (PTDM) is associated with overall renal graft loss, but not death-censored graft loss.In this single-center retrospective cohort study of 2749 adult Norwegian renal transplant recipients, transplanted between 1999 and 2011, we estimated overall and death-censored renal graft loss hazard ratios in patients diagnosed with PTDM, impaired glucose tolerance and diabetes before transplantation, using multivariable Cox proportional hazard regression analysis.A total of 893 renal grafts were lost during the study period, either due to recipient death (n = 540) or death-censored graft loss (n = 353).When the observational time started at time of transplantation, diabetes before transplantation was associated with both overall and death-censored graft loss. Pretransplantation diabetes was also associated with a steeper decline in renal graft function, a higher risk of acute rejections and more renal grafts lost due to acute rejection.In patients with a functional renal graft 1 year after transplantation, PTDM was associated with overall graft loss (hazard ratio, 1.46; 95% confidence interval, 1.13-1.88; P0.001), but not death-censored graft loss (hazard ratio, 1.25; 95% confidence interval, 0.80-1.96; P = 0.33). We found no significant associations between PTDM and change in renal function during the first 5 years or acute rejection risk during the first year after renal transplantation.Impaired glucose tolerance was not associated with either overall or death-censored graft loss.The present study confirms previous findings of an increased risk of overall but not death-censored renal graft loss in renal transplant recipients with PTDM. Longstanding diabetes might increase the risk of acute rejections. |
| Databáze: | OpenAIRE |
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