New-onset diabetes mellitus after kidney transplantation: Current status and future directions

被引:91
作者
Palepu, Sneha [1 ]
Prasad, G. V. Ramesh [1 ]
机构
[1] Univ Toronto, St Michaels Hosp, Div Nephrol, Toronto, ON M5C 2T2, Canada
来源
WORLD JOURNAL OF DIABETES | 2015年 / 6卷 / 03期
关键词
Cyclosporine; Graft; Kidney; New-onset diabetes; Tacrolimus; Transplantation;
D O I
10.4239/wjd.v6.i3.445
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
A diagnosis of new-onset diabetes after transplantation (NODAT) carries with it a threat to the renal allograft, as well as the same short-and long-term implications of type 2 diabetes seen in the general population. NODAT usually occurs early after transplantation, and is usually diagnosed according to general population guidelines. Non-modifiable risk factors for NODAT include advancing age, African American, Hispanic, or South Asian ethnicity, genetic background, a positive family history for diabetes mellitus, polycystic kidney disease, and previously diagnosed glucose intolerance. Modifiable risk factors for NODAT include obesity and the metabolic syndrome, hepatitis C virus and cytomegalovirus infection, corticosteroids, calcineurin inhibitor drugs (especially tacrolimus), and sirolimus. NODAT affects graft and patient survival, and increases the incidence of post-transplant cardiovascular disease. The incidence and impact of NODAT can be minimized through pre- and post-transplant screening to identify patients at higher risk, including by oral glucose tolerance tests, as well as multi-disciplinary care, lifestyle modification, and the use of modified immunosuppressive regimens coupled with glucose-lowering therapies including oral hypoglycemic agents and insulin. Since NODAT is a major cause of post-transplant morbidity and mortality, measures to reduce its incidence and impact have the potential to greatly improve overall transplant success.
引用
收藏
页码:445 / 455
页数:11
相关论文
共 50 条
  • [21] New-Onset Diabetes After Kidney Transplantation: Prevalence, Risk Factors, and Management
    Sarno, Gerardo
    Muscogiuri, Giovanna
    De Rosa, Paride
    TRANSPLANTATION, 2012, 93 (12) : 1189 - 1195
  • [22] New-onset diabetes after transplantation: a review of recent literature
    Balla, Ashfaq
    Chobanian, Michael
    CURRENT OPINION IN ORGAN TRANSPLANTATION, 2009, 14 (04) : 375 - 379
  • [23] New-onset diabetes after transplantation
    Pavlakis M.
    Current Diabetes Reports, 2005, 5 (4) : 300 - 304
  • [24] New-onset diabetes mellitus following pediatric liver transplantation
    Kapoor, Ritika R.
    PEDIATRIC TRANSPLANTATION, 2013, 17 (01) : 5 - 7
  • [25] New-onset diabetes mellitus presenting with diabetic ketoacidosis after pediatric liver transplantation
    Dehghani, Seyed Mohsen
    Nikeghbalian, Saman
    Eshraghian, Ahad
    Haghighat, Mahmood
    Imanieh, Mohammad Hadi
    Bahador, Ali
    Kazemi, Kourosh
    Malek-Hosseini, Seyed Ali
    PEDIATRIC TRANSPLANTATION, 2009, 13 (05) : 536 - 539
  • [26] Prevalence of new-onset diabetes mellitus after kidney transplantation: a systematic review and meta-analysis
    Du, Qiufeng
    Li, Tao
    Yi, Xiaodong
    Song, Shuang
    Kang, Jing
    Jiang, Yunlan
    ACTA DIABETOLOGICA, 2024, 61 (07) : 809 - 829
  • [27] New-Onset Diabetes and Nephropathy after Renal Transplantation
    Guitard, Joelle
    Rostaing, Lionel
    Kamar, Nassim
    DIABETES AND THE KIDNEY, 2011, 170 : 247 - 255
  • [28] New-onset diabetes after renal transplantation: A case series as seen in a Nigerian kidney transplant population
    Adamu, B.
    Uloko, A. E.
    Aliyu, A.
    A'isha, N.
    NIGERIAN JOURNAL OF CLINICAL PRACTICE, 2013, 16 (02) : 263 - 265
  • [29] Role of insulin resistance indices in predicting new-onset diabetes after kidney transplantation
    Nagaraja, Pramod
    Ravindran, Vinod
    Morris-Stiff, Gareth
    Baboolal, Kesh
    TRANSPLANT INTERNATIONAL, 2013, 26 (03) : 273 - 280
  • [30] An Analysis of the Risk Factors for New-Onset Diabetes Mellitus After Liver Transplantation
    Sun, Jushan
    He, Yibiao
    Bai, Lei
    Wang, Zhipeng
    Cao, Zhu
    Shao, Yingmei
    Zhao, Jinming
    INTERNATIONAL JOURNAL OF GENERAL MEDICINE, 2021, 14 : 4783 - 4792