Title: New Onset Diabetes after Renal Transplantation (NODAT): Prevalence, Risk Factors and Treatment
Authors: Lakshminarayana GR, Sheetal LG, Anil M, Rajesh R, George K, Unni VN
DOI: http://dx.doi.org/10.18535/jmscr/v4i1.30
Abstract
Background:This study was conducted to assess the prevalence rate, risk factors and response to treatment of NODAT after renal transplantation.
Methods:All consecutive non-diabetic renal transplant recipients (RTR) from 2005 to 2011; done at AIMS, Kochi, were included in the study. ADA criteria (2003) for NODAT was for its diagnosis.
Results:The study group included 125 (M:101, F:24) RTRs with a mean age of 31.53 years, with a mean follow-up of 32.01 months after surgery. The prevalence rate of NODAT was 23%. Majority (80 %) of recipients with NODAT, had it within first 6 months after surgery. The prevalence rate of NODAT was higher males and those aged >40 years. The prevalence rate of NODAT was higher in those with family history of diabetes mellitus and pre-transplant impaired glucose levels.The prevalence rate of NODAT was higher with Tacrolimus based regimen and also those receiving methyl prednisolone as part of antirejection therapy. Majority (55 %) of those with NODAT had normal BMI. The prevalence of graft dysfunction was higher in those with NODAT.
Conclusions: The prevalence rate of NODAT was 23%, with a peak incidence in initial 6 months after renal transplantation. The non-modifiable risk factors for NODAT were; age > 40 years, male gender, pre-transplant impaired glucose levels and family history of diabetes mellitus. The modifiable risk factors for NODAT were; immunosuppressive drugs (Tacrolimus > Cyclosporine A), antirejection therapy with Methyl prednisolone. The prevalence of graft dysfunction was higher in those with NODAT than those without NODAT.
Key Words: NODAT, Renal transplantation, Modifiable risk factors, non-modifiable risk factors,
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