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Abstract
Aim: To assess the Post-transplant diabetes mellitus incidence and determine the other factors which may play a role in this complication development.
Method: 105 non-DM study population included in this study transplanted renal allograft, since 1999. Post-transplant diabetes mellitus was identified by the requirement of the hypoglycemic drug which started after transplantation by a range of more than one month. All patients after transplantation received prednisone and cyclosporine and no one received tacrolimus.
Results: At 1st, 3rd, 5th, and 10th years follow up after transplantation, five, eight, eleven and lastly nineteen percent developing Post-transplant diabetes mellitus., the correlated variables was determined as independent variables for the rapid increment in the Post-transplant diabetes mellitus numbers, which, higher BMI- before transplant, age of recipient the younger than 45 years significantly differ from older age with P < 0.0001
Conclusions: Post-transplant diabetes mellitus risk continuously increases with post-transplant time. Transplanted patients show increment in Post-transplant diabetes mellitus incidence whose recipients characteristics changes is the full explanation of this matter. The assumption of a cause of this increment is due to the introduction of better absorbed CsA formulations, which resulted in higher diabetogenic drug cumulative exposure in addition to other factors.
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References
- Schweitzer, EJ, Matas, AJ & Gillingham, KJ, et al: Causes of renal allograft loss: Progress in the 1980s, challenges for the 1990s. Ann Surg 1991214: 679–688,
- The Tricontinental Mycophenolate Mofetil Renal Transplantation Study Group: A blinded, randomized clinical trial of Mycophenolate Mofetil for the prevention of acute rejection in cadaveric renal transplantation. Transplantation 199661: 1029–1037,
- Hariharan, S, Johnson, CP & Breshnahan, BA, et al: Improved graft survival after renal transplantation in the United States, 1988 to 1996. N Engl J Med 2000342: 605–612Cosio, FG, Alamir, A & Yim, S, et al: Patient survival after renal transplantation. I. The impact of dialysis pre-transplant. Kidney Int 199853: 767–772,
- Ojo, AO, Hanson, JA & Wolfe, RA, et al: Long-term survival in renal transplant recipients with graft function. Kidney Int 200057: 307–313, 10.1046/j.1523-1755.2000.00816.x
- USRDS: United States Renal Data System 1996 annual data report. Am J Kidney Dis 199628: S1–S152,
- Kasiske, BL: Risk factors for cardiovascular disease after renal transplantation. Miner Electrolyte Metab 199319: 186–195, |
- Cosio, FG, Falkenhain, ME & Pesavento, TE, et al: Patient survival after renal transplantation. II. The impact of smoking. Clin Transplant 199913: 336–341 |
- Foley, RN, Parfrey, PS & Sarnak, MJ: Clinical epidemiology of cardiovascular disease in chronic renal disease. Am J Kidney Dis 199832(Suppl 3):S112–S119, |
- Osei, K: Insulin resistance and systemic hypertension. Am J Cardiol 199984: 33J–36J, |
- Reaven, GM, Lithell, H & Landsberg, L: Hypertension and associated metabolic abnormalities: The role of insulin resistance and the sympathoadrenal system. N Engl J Med 1996334: 374–381, |
- Weir, M & Fink, J: Risk for posttransplant diabetes mellitus with current immunosuppressive medications. Am J Kidney Dis 199934: 1–13, |
- Pirsch, JD, Miller, J & Deierhoi, MH, et al: A comparison of tacrolimus (FK506) and cyclosporine for immunosuppression after cadaveric renal transplantation. Transplantation 199763: 977–983, |
- Ritz, E, Rychlik, I & Locatelli, F, et al: End-stage renal failure in type 2 diabetes: A medical catastrophe of worldwide dimensions. Am J Kidney Dis 199934: 795–808 |
- Osei, K, Gaillard, T & Schuster, DP: Pathogenetic mechanisms of impaired glucose tolerance and type II diabetes in African-Americans. Diabetes Care 199720: 396–404 |
- Osei, K & Schuster, DP: Ethnic differences in secretion, sensitivity, and hepatic extraction of insulin in black and white Americans. Diabet Med 199411: 755–762 |
- Neilsen, JH, Mandrup-Poulsen, T & Nerup, J: Direct effects of cyclosporine A on human pancreatic beta-cells. Diabetes 198635: 1049–1052, Gillison, SL, Bartlett, ST & Curry, DL: Inhibition by cyclosporine of insulin secretion-A beta cell-specific alteration of islet tissue function. Transplantation 199152: 890–895,
References
Schweitzer, EJ, Matas, AJ & Gillingham, KJ, et al: Causes of renal allograft loss: Progress in the 1980s, challenges for the 1990s. Ann Surg 1991214: 679–688,
The Tricontinental Mycophenolate Mofetil Renal Transplantation Study Group: A blinded, randomized clinical trial of Mycophenolate Mofetil for the prevention of acute rejection in cadaveric renal transplantation. Transplantation 199661: 1029–1037,
Hariharan, S, Johnson, CP & Breshnahan, BA, et al: Improved graft survival after renal transplantation in the United States, 1988 to 1996. N Engl J Med 2000342: 605–612Cosio, FG, Alamir, A & Yim, S, et al: Patient survival after renal transplantation. I. The impact of dialysis pre-transplant. Kidney Int 199853: 767–772,
Ojo, AO, Hanson, JA & Wolfe, RA, et al: Long-term survival in renal transplant recipients with graft function. Kidney Int 200057: 307–313, 10.1046/j.1523-1755.2000.00816.x
USRDS: United States Renal Data System 1996 annual data report. Am J Kidney Dis 199628: S1–S152,
Kasiske, BL: Risk factors for cardiovascular disease after renal transplantation. Miner Electrolyte Metab 199319: 186–195, |
Cosio, FG, Falkenhain, ME & Pesavento, TE, et al: Patient survival after renal transplantation. II. The impact of smoking. Clin Transplant 199913: 336–341 |
Foley, RN, Parfrey, PS & Sarnak, MJ: Clinical epidemiology of cardiovascular disease in chronic renal disease. Am J Kidney Dis 199832(Suppl 3):S112–S119, |
Osei, K: Insulin resistance and systemic hypertension. Am J Cardiol 199984: 33J–36J, |
Reaven, GM, Lithell, H & Landsberg, L: Hypertension and associated metabolic abnormalities: The role of insulin resistance and the sympathoadrenal system. N Engl J Med 1996334: 374–381, |
Weir, M & Fink, J: Risk for posttransplant diabetes mellitus with current immunosuppressive medications. Am J Kidney Dis 199934: 1–13, |
Pirsch, JD, Miller, J & Deierhoi, MH, et al: A comparison of tacrolimus (FK506) and cyclosporine for immunosuppression after cadaveric renal transplantation. Transplantation 199763: 977–983, |
Ritz, E, Rychlik, I & Locatelli, F, et al: End-stage renal failure in type 2 diabetes: A medical catastrophe of worldwide dimensions. Am J Kidney Dis 199934: 795–808 |
Osei, K, Gaillard, T & Schuster, DP: Pathogenetic mechanisms of impaired glucose tolerance and type II diabetes in African-Americans. Diabetes Care 199720: 396–404 |
Osei, K & Schuster, DP: Ethnic differences in secretion, sensitivity, and hepatic extraction of insulin in black and white Americans. Diabet Med 199411: 755–762 |
Neilsen, JH, Mandrup-Poulsen, T & Nerup, J: Direct effects of cyclosporine A on human pancreatic beta-cells. Diabetes 198635: 1049–1052, Gillison, SL, Bartlett, ST & Curry, DL: Inhibition by cyclosporine of insulin secretion-A beta cell-specific alteration of islet tissue function. Transplantation 199152: 890–895,
