Details
| Original language | English |
|---|---|
| Pages (from-to) | 512-519 |
| Number of pages | 8 |
| Journal | Clinical Transplantation |
| Volume | 28 |
| Issue number | 4 |
| Early online date | 21 Mar 2014 |
| Publication status | Published - Apr 2014 |
| Externally published | Yes |
Abstract
Although major risk factors for post-transplant diabetes (PTDM) after kidney transplantation have been identified, a systematic study on the impact of rejection and rejection therapy is missing so far. Methods: Five hundred and twenty-six kidney transplant recipients transplanted in the years 2000-2007 were included. PTDM was defined according to WHO guidelines, and patients' data were compared with special attention to protocol and for cause biopsies and rejection therapies. Survival analyses were made for graft loss and patient death. Results: 16.7% of all patients developed PTDM. Among common risk factors as higher age, body mass index (BMI), and others, the factor "acute cellular rejections" was comparably most relevant with a hazard ratio of 3.7. Consequently, antirejective treatment with steroid pulses and conversion to tacrolimus was the factor with the highest relative risk for the onset of PTDM (RR 3.5). PTDM itself had no impact on graft or patients' survival, but the decreased graft survival in PTDM patients was dominantly influenced by the higher frequency of acute cellular rejections, and patients' survival was reduced due to higher age. Conclusion: Based upon a higher rate of acute rejections (AR), the necessity of frequent antirejective treatments was more relevant for the induction of PTDM than age or BMI.
Keywords
- Immunosuppressive therapy, PTDM, Rejection therapy, Renal transplant biopsies
ASJC Scopus subject areas
- Medicine(all)
- Transplantation
Sustainable Development Goals
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In: Clinical Transplantation, Vol. 28, No. 4, 04.2014, p. 512-519.
Research output: Contribution to journal › Article › Research › peer review
}
TY - JOUR
T1 - High impact of rejection therapy on the incidence of post-transplant diabetes mellitus after kidney transplantation
AU - Schweer, Torben
AU - Gwinner, Wilfried
AU - Scheffner, Irina
AU - Schwarz, Anke
AU - Haller, Hermann
AU - Blume, Cornelia
PY - 2014/4
Y1 - 2014/4
N2 - Although major risk factors for post-transplant diabetes (PTDM) after kidney transplantation have been identified, a systematic study on the impact of rejection and rejection therapy is missing so far. Methods: Five hundred and twenty-six kidney transplant recipients transplanted in the years 2000-2007 were included. PTDM was defined according to WHO guidelines, and patients' data were compared with special attention to protocol and for cause biopsies and rejection therapies. Survival analyses were made for graft loss and patient death. Results: 16.7% of all patients developed PTDM. Among common risk factors as higher age, body mass index (BMI), and others, the factor "acute cellular rejections" was comparably most relevant with a hazard ratio of 3.7. Consequently, antirejective treatment with steroid pulses and conversion to tacrolimus was the factor with the highest relative risk for the onset of PTDM (RR 3.5). PTDM itself had no impact on graft or patients' survival, but the decreased graft survival in PTDM patients was dominantly influenced by the higher frequency of acute cellular rejections, and patients' survival was reduced due to higher age. Conclusion: Based upon a higher rate of acute rejections (AR), the necessity of frequent antirejective treatments was more relevant for the induction of PTDM than age or BMI.
AB - Although major risk factors for post-transplant diabetes (PTDM) after kidney transplantation have been identified, a systematic study on the impact of rejection and rejection therapy is missing so far. Methods: Five hundred and twenty-six kidney transplant recipients transplanted in the years 2000-2007 were included. PTDM was defined according to WHO guidelines, and patients' data were compared with special attention to protocol and for cause biopsies and rejection therapies. Survival analyses were made for graft loss and patient death. Results: 16.7% of all patients developed PTDM. Among common risk factors as higher age, body mass index (BMI), and others, the factor "acute cellular rejections" was comparably most relevant with a hazard ratio of 3.7. Consequently, antirejective treatment with steroid pulses and conversion to tacrolimus was the factor with the highest relative risk for the onset of PTDM (RR 3.5). PTDM itself had no impact on graft or patients' survival, but the decreased graft survival in PTDM patients was dominantly influenced by the higher frequency of acute cellular rejections, and patients' survival was reduced due to higher age. Conclusion: Based upon a higher rate of acute rejections (AR), the necessity of frequent antirejective treatments was more relevant for the induction of PTDM than age or BMI.
KW - Immunosuppressive therapy
KW - PTDM
KW - Rejection therapy
KW - Renal transplant biopsies
UR - http://www.scopus.com/inward/record.url?scp=84899127866&partnerID=8YFLogxK
U2 - 10.1111/ctr.12329
DO - 10.1111/ctr.12329
M3 - Article
C2 - 24649873
AN - SCOPUS:84899127866
VL - 28
SP - 512
EP - 519
JO - Clinical Transplantation
JF - Clinical Transplantation
SN - 0902-0063
IS - 4
ER -