Long-term Outcomes of Post-transplant Diabetes Mellitus in Renal Transplant Recipients

Kang, Jinmo; Yu, Seung Beom; Yun, Ik Jin; Lee, Tae Seung; Chung, In Mok; Chung, Jung Kee; Ha, Jongwon; Kim, Sang Joon

Abstract

PURPOSE
Post-transplant diabetes mellitus (PTDM) is believed to cause serious complications. PTDM might be one of the important risk factors of cardiovascular death after renal transplantation. Because the consequence of PTDM is expected to take long time, long-term follow-up is necessary. We performed this study not only to define the prevalence and risk factors of PTDM but also to define the long-term clinical impact of PTDM.
METHODS
Among 508 patients who had received renal transplantation at Seoul National University Hospital between July 1969 and December 1995, 431 patients were included. Patients were grouped into PTDM and non-DM groups. The clinical characteristics were compared between two groups.
RESULTS
Mean follow-up duration was 121.9 months (2~346 months). PTDM was developed in 68 (15.8%) patients. Recipient age at transplantation (P=0.004), family history of DM (P=0.000) and obesity (P= 0.000) were significant risk factors in multivariate analysis. Complications of PTDM such as cerebrovascular disease (CVD, P=0.040), ischemic heart disease (IHD, P=0.040), and infection (p=0.044) were significantly more frequent in PTDM group. The frequency of chronic allograft nephropathy (CAN) was not different between two groups. Although graft survival rate was not affected by PTDM, patient survival rate was significantly lower in PTDM group (P=0.002).
CONCLUSION
PTDM increased complication rates such as CVD, IHD and infection. PTDM seemed not to affect graft survival, but to worsen the patient survival rate.