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Model predicted new-onset diabetes after kidney transplantation
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A pretransplant predictive risk model predicted new-onset diabetes after kidney transplantation, results from a recent study suggest.
According to Harini A. Chakkera, MD, MPH, of the divisions of nephrology and transplantation at the Mayo Clinic in Scottsdale, Ariz., and colleagues, there is a fivefold to sixfold greater annual incidence of new-onset diabetes in the first year after transplantation compared with subsequent years.
“Identification of pretransplant risk factors may help to explain why new-onset diabetes after transplantation (NODAT) develops in only some individuals, even though all are exposed to similar transplant immunosuppression, many of which (calcineurin inhibitors, mTOR inhibitors, and glucocorticoids) are also diabetogenic,” researchers wrote.
Harini A. Chakkera
In a previously presented model, researchers utilized variables for age, planned use of maintenance corticosteroids, prescription for gout medicine, BMI, fasting glucose, fasting triglycerides and family history of diabetes.
To further validate this model, the researchers conducted two analyses — standard and summary score — among 474 kidney transplant recipients compared with the previous cohort (n=318). The frequency of low-risk, medium-risk and high-risk factors were similar between the new cohort (12%, 29%, 56%) vs. the previous cohort (11%, 29%, 51%), according to data.
“This risk model for NODAT was developed for a specific population of kidney transplant recipients, and its generalizability to recipients of other solid organs will need to be tested. NODAT is a significant problem after liver and heart transplantation, with reported incidence rates of 20% to 40%,” researchers wrote. “It will be important to determine if risk factors for diabetes after transplantation of other solid organs are similar to those for type 2 diabetes.”
Disclosure: The researchers report no relevant financial disclosures.
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