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Risk factors for developing posttransplant diabetes after pediatric kidney transplant in a Canadian tertiary care children's hospital between 1995-2016

Risk factors for developing posttransplant diabetes after pediatric kidney transplant in a Canadian tertiary care children's hospital between 1995-2016
Risk factors for developing posttransplant diabetes after pediatric kidney transplant in a Canadian tertiary care children's hospital between 1995-2016
Background: posttransplant diabetes mellitus (PTDM) is a serious complication in kidney transplant recipients (KTRs) due to its negative impact on graft and patient survival. Although reported in 3% to 20% of pediatric KTRs, it has not been as well characterized in adults. In this study we describe incidence and risk factors associated with development of PTDM in pediatric KTRs.
Methods: this work is a retrospective cohort study of nondiabetic pediatric patients, aged 6 months to 19 years, who underwent a first kidney transplant during 1995 to 2016. We estimated the cumulative incidence rate and used multivariable logistic regression to identify the diabetogenic risk factors for PTDM.

Results: a total of 142 KTRs were included in this study. The cumulative incidence of PTDM was 31% and 14.1% in the first and second year posttransplant, respectively. Significant risk factors for PTDM in the first year after transplant included: dysglycemia in the first 8 to 30 days posttransplant (adjusted odds ratio [aOR], 3.02; 95% confidence interval [CI], 1.21 to 7.53; p=0.018) and use of sirolimus in the first 30 days posttransplant (aOR, 5.33; 95% CI, 1.16 to 24.35; p=0.031). No significant association was found with typical diabetogenic factors.

Conclusions: the incidence of PTDM is high among pediatric KTRs. Independent risk factors associated with PTDM included meeting the criteria for dysglycemia or diabetes and sirolimus use in the first month posttransplant. Typical diabetogenic risk factors for type 2 diabetes were not associated with increased risk. This study provides valuable information for posttransplant medical care and future research.
481-489
Acosta-Gualandri, Alejandra
5eb4b652-54b0-4154-9cac-e7521a76fdb8
Blydt-Hansen, Tom
0d640ee2-b5df-4e85-b456-8e5e0f680cc2
Islam, Nazrul
e5345196-7479-438f-b4f6-c372d2135586
Amed, Shazhan
c3afda99-2743-404a-ba72-38eb0fcc69dc
Acosta-Gualandri, Alejandra
5eb4b652-54b0-4154-9cac-e7521a76fdb8
Blydt-Hansen, Tom
0d640ee2-b5df-4e85-b456-8e5e0f680cc2
Islam, Nazrul
e5345196-7479-438f-b4f6-c372d2135586
Amed, Shazhan
c3afda99-2743-404a-ba72-38eb0fcc69dc

Acosta-Gualandri, Alejandra, Blydt-Hansen, Tom, Islam, Nazrul and Amed, Shazhan (2021) Risk factors for developing posttransplant diabetes after pediatric kidney transplant in a Canadian tertiary care children's hospital between 1995-2016. Canadian Journal of Diabetes, 45 (5), 481-489. (doi:10.1016/j.jcjd.2021.05.004).

Record type: Article

Abstract

Background: posttransplant diabetes mellitus (PTDM) is a serious complication in kidney transplant recipients (KTRs) due to its negative impact on graft and patient survival. Although reported in 3% to 20% of pediatric KTRs, it has not been as well characterized in adults. In this study we describe incidence and risk factors associated with development of PTDM in pediatric KTRs.
Methods: this work is a retrospective cohort study of nondiabetic pediatric patients, aged 6 months to 19 years, who underwent a first kidney transplant during 1995 to 2016. We estimated the cumulative incidence rate and used multivariable logistic regression to identify the diabetogenic risk factors for PTDM.

Results: a total of 142 KTRs were included in this study. The cumulative incidence of PTDM was 31% and 14.1% in the first and second year posttransplant, respectively. Significant risk factors for PTDM in the first year after transplant included: dysglycemia in the first 8 to 30 days posttransplant (adjusted odds ratio [aOR], 3.02; 95% confidence interval [CI], 1.21 to 7.53; p=0.018) and use of sirolimus in the first 30 days posttransplant (aOR, 5.33; 95% CI, 1.16 to 24.35; p=0.031). No significant association was found with typical diabetogenic factors.

Conclusions: the incidence of PTDM is high among pediatric KTRs. Independent risk factors associated with PTDM included meeting the criteria for dysglycemia or diabetes and sirolimus use in the first month posttransplant. Typical diabetogenic risk factors for type 2 diabetes were not associated with increased risk. This study provides valuable information for posttransplant medical care and future research.

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Acosta_Gualandri_CanJDiab_2021_Author_Version - Accepted Manuscript
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Accepted/In Press date: 10 April 2021
Published date: 24 June 2021

Identifiers

Local EPrints ID: 470565
URI: http://eprints.soton.ac.uk/id/eprint/470565
PURE UUID: 2eb5c435-e729-4672-a1cb-43ca20bc89a6
ORCID for Nazrul Islam: ORCID iD orcid.org/0000-0003-3982-4325

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Date deposited: 13 Oct 2022 16:34
Last modified: 17 Mar 2024 04:15

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Contributors

Author: Alejandra Acosta-Gualandri
Author: Tom Blydt-Hansen
Author: Nazrul Islam ORCID iD
Author: Shazhan Amed

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