Medizinische Universität Graz - Research portal
Selected Publication:
Pinz, N.
The impact of post-transplant diabetes mellitus on cardiovascular outcomes after kidney transplantation
Humanmedizin; [ Diplomarbeit ] Medizinische Universität Graz; 2023. pp. 64
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- Authors Med Uni Graz:
- Advisor:
- Deak Andras Tamas
- Kirsch Alexander
- Altmetrics:
- Abstract:
- Background: Post-transplant diabetes mellitus (PTDM) is a common complication after kidney transplantation (KT), which has a negative impact on cardiovascular (CV) and renal outcomes. The Austrian data availability on the consequences of PTDM and the incidence of its occurrence is limited. Materials and methods: In this retrospective chart-review n=619 patients who received their KT at our centre between 2005-2019 were included. PTDM was diagnosed at 52±8 weeks post-KT through pathological HbA1c-value (>6.5%) or an ongoing therapy with antidiabetic medication at that time without pre-existing diabetes mellitus prior to KT. 29 patients died in the first year post-KT, before PTDM could be diagnosed, thus, they were excluded from the final analysis. The short-term (2-year) incidence of major adverse cardiac events (MACE), a combined endpoint of mortality, non-fatal acute coronary syndrome, heart failure, or cerebrovascular event, was used as an outcome variable. Further, a Kaplan-Meier analysis of long-term mortality was performed. Results: Our patient collective – 65.9% male – showed a median age of 51.2 years. The prevalence of diabetes mellitus (DM) was 14.54%, while the incidence of PTDM 1-year after KT was 11.63%. 36.1% of PTDM patients used insulin, while 65.3% were treated with oral antidiabetics. MACE occurred in 30 KT recipients within 2 years following KT. During a median follow-up of 84 months, a total of 55 patients died. No significant differences between the three study groups (DM, PTDM, non DM) were found, both concerning MACE (log-rank p= 0.911) and all-cause mortality (log-rank p=0.0604). The mean serum creatinine 1-year post-transplant was 1.66 mg/dl without significant differences between the groups. Conclusion: Our study shows a PTDM-incidence of 11.63% 1-year post-transplant in a large Austrian patient collective. PTDM had no negative effect on short-term CV outcome or long-term survival. The informative value of our study is limited due to its retrospective character and the fact, that the oral glucose tolerance test (OGTT) is not part of the routine follow-up post-KT, thus, the incidence of PTDM could be underestimated.