NEW ONSET OF DIABETES MELLITUS IN INDIAN RENAL TRANSPLANT RECIPIENT-A RETROSPECTIVE STUDY
Keywords:
New-onset of diabetes, Immunosuppressant drug, Kidney transplant, Infection, Calciurine inhibitorAbstract
Objective: To identify incidence and determinant of new-onset of diabetes after transplant (NODAT) in Indian renal transplant recipients.
Methods: In this study Indian renal transplant recipients who were not diabetic before transplant and underwent kidney transplantation between July 2004 and June 2011 were enrolled. Various data of all transplant patients including age, gender, body weight, pre transplant Hepatitis C virus (HCV), Hepatitis B virus (HBV) infection status, Human Leukocyte Antigens (HLA) mismatch, maintenance immunosuppressant drug, usage of antibodies, anti rejection treatment, patients and graft survival, post-transplant infection including HCV, HBV, Herpes and Cytomegalo virus (CMV) infection were noted down. In this study patients who had taken anti diabetic medicine beyond 1 month were considered as diabetic.
Results: Total 537 renal transplant recipients were enrolled in the study. Patients age (P<0.0001), body weight (P=0.042) and HLA mismatch (P=0.015) were significantly effected on prevalence of NODAT. Other parameters like sex (P=0.862), type of donor (P=0.191), pre transplant HBV (P=0.285) and pre transplant HCV (P=0.201) were not significantly affecting development of NODAT. NODAT prevalence was not significantly affected by different Calciurine Inhibitors (CNIs) (P=0.079), antibodies (P=0.671) and by anti rejection therapy (P=0.115). Post-transplant infection was significantly higher in NODAT patients (P=0.022) and mainly among them CMV infection was prevalent (P=0.002). Other infections were found similar in patients with or without NODAT. NODAT was not significantly affecting patients survival (P=0.828) and graft survival (P=0.101).
Conclusion: Age more than 45 years, body weight more than 70 kilogram, HLA mismatch, tacrolimus treatment are significantly affecting development of NODAT in Indian transplant recipients. NODAT is strongly associated with development of post-transplant infection and among them CMV infection was prevalent.
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