Pretransplantation Risk Factors Associated With New-onset Diabetes After Living-donor Kidney Transplantation

- New-onset diabetes mellitus after transplantation (NODAT) is a troublesome complication with the increased length of follow-up.
- As the largest center of living-donor kidney transplantation in China, we have observed that many recipients had suffered from NODAT, which prompted us to determine the pretransplantation risk factors for NODAT.
- The results of our research may help other transplantation surgeons identify and manage high-risk recipients.

Mid-term date of kidney recipients with new-onset diabetes mellitus after transplantation (NODAT) was poor. We made a retrospective study of 397 patients who had living-donor kidney transplantation between January 2007 and May 2010 in our center. Pretransplantation risk factors for NODAT were identified by univariate and multivariate analyses. The mean follow-up was 53.5 ± 10.4 months. The prevalence of NODAT was 9.3%. Univariate analyses found the mean recipient age ≥40 years, body mass index (BMI) ≥24 kg/m2, family history of diabetes, fasting blood glucose (FBG) ≥5.6 mmol/L, 2-hour plasma glucose ≥7.8 mmol/L, and tacrolimus were risk factors for NODAT. In logistic regression, BMI ≥24 kg/m2 (odds ratio [OR]: 4.14, confidence interval [CI]: 2.02 ∼ 8.49, P < .001), family history of diabetes (OR: 2.62, CI: 1.09 ∼ 6.34, P = .032), and FBG ≥5.6 mmol/L (OR: 3.21, CI: 1.52 ∼ 6.79, P = .002) were independent risk factors. In conclusion, the mid-term prevalence of NODAT in Chinese renal recipients was low (9.3%). Pretransplantation independent risk factors were BMI ≥24 kg/m2, family history of diabetes, and FBG ≥5.6 mmol/L; thus identifying which factors might help to prevent NODAT.