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Glucose tolerance before and after renal transplantation
- Source :
- Nephrology Dialysis Transplantation. 25:985-992
- Publication Year :
- 2009
- Publisher :
- Oxford University Press (OUP), 2009.
-
Abstract
- Background. Renal insufficiency predisposes to insulin resistance, hyperparathyroidism and derangements in calcium phosphate and nitrogenous compound balance, leading to pre-transplant hyperglycaemia. These metabolic risk factors are not fully corrected after renal transplantation. The present study aimed to assess the role of pre-transplant glycaemia and the named metabolic risk factors in posttransplant hyperglycaemia [PHYG; impaired fasting glucose (IFG), impaired glucose tolerance (IGT) or diabetes mellitus (DM)]. Methods. This is a retrospective cohort study involving 301 patients without pre-transplant DM. Measurements included a pre- and post-transplant oral glucose tolerance test (OGTT) as well as glomerular filtration rate (GFR), parathyroid hormone (PTH), phosphate, calcium and urea measured 10 weeks post-transplant. The risk of PHYG at 10 weeks post-transplant was analysed using multiple logistic regression. Results. Ninety-three patients (31%) had PHYG (two IFG, 52 IGT, 39 DM). Variables associated with PHYG included pre-transplant 2-h glycaemia [OR 1.26, 95% CI (1.09, 1.46)] and post-transplant urea levels [OR 1.14, 95% CI (1.02, 1.27)]. Older age, non-Caucasian ethnicity, previous transplants, ≥3 HLA class 1 mismatches and high prednisolone doses were likewise associated with an increased PHYG risk (all P < 0.05). Conclusions. Pre-transplant glycaemia and high posttransplant levels of urea were associated with a greater risk of PHYG. This seemed to be independent of GFR, PTH, phosphate, calcium and traditional risk factors such as age and glucocorticoid load.
- Subjects :
- Adult
Male
medicine.medical_specialty
Renal function
Cohort Studies
Impaired glucose tolerance
Insulin resistance
Predictive Value of Tests
Risk Factors
Internal medicine
Diabetes mellitus
Glucose Intolerance
Diabetes Mellitus
medicine
Humans
Renal Insufficiency
Retrospective Studies
Transplantation
Glucose tolerance test
Hyperparathyroidism
medicine.diagnostic_test
business.industry
Racial Groups
Age Factors
Glucose Tolerance Test
Middle Aged
medicine.disease
Impaired fasting glucose
Kidney Transplantation
Endocrinology
Nephrology
Hyperglycemia
Female
business
hormones, hormone substitutes, and hormone antagonists
Glomerular Filtration Rate
Subjects
Details
- ISSN :
- 14602385 and 09310509
- Volume :
- 25
- Database :
- OpenAIRE
- Journal :
- Nephrology Dialysis Transplantation
- Accession number :
- edsair.doi.dedup.....4b16effc0f0330330aab9bc1e86a3a2c