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new onset diabetes after kidney transplantation

Hassan Aleid, Ahmad Alhuraiji, Abdullah Alqaraawi, Ammar Abdulbaki, Mai Altalhi, Mohamed Shoukri, Eldali Abdelmoneim, Tariq Ali
Many patients develop new-onset diabetes after kidney transplantation (NODAT). Its incidence and epidemiology are unknown in the Saudi population. We aimed to study the incidence, epidemiology, and outcomes of kidney transplant recipients who developed NODAT. This is a retrospective study of all adults who received kidney transplant between January 2003 and December 2009. NODAT was defined according to the criteria outlined in the 2003 International Consensus guidelines. A total of 500 patients were included in this study, 54% were male patients...
November 2016: Saudi Journal of Kidney Diseases and Transplantation
Marit Elizabeth von Düring, Trond Jenssen, Jens Bollerslev, Anders Åsberg, Kristin Godang, Anders Hartmann
Body composition after kidney transplantation is linked to glucose metabolism, and impaired glucose metabolism is associated with increased risk of cardiovascular events and death. One year after transplantation we examined 150 patients for new-onset diabetes performing OGTTs and body composition measurements including visceral adipose tissue (VAT) content from dual-energy X-ray absorptiometry scans. We found that glucose metabolism was generally improved and that the levels of VAT and percentage VAT of total body fat mass (VAT%totBFM ) were lowest in those with normal glucose tolerance and highest in those with post transplant diabetes mellitus...
November 16, 2016: Clinical Transplantation
Norberto Perico, Monica Cortinovis, Giuseppe Remuzzi
Transplantation is the optimal choice for renal replacement therapy in patients with autosomal dominant polycystic kidney disease (ADPKD). However, some specific issues should be addressed before transplantation, including nephrectomy of native kidneys, cystic liver involvement, screening for intracranial aneurysms and living related-donor transplantation. After kidney transplantation, patient and graft survival rates are excellent and the size of native kidneys typically declines. Nevertheless, a number of renal and extrarenal complications have been documented in kidney transplant recipients with ADPKD...
September 2016: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
Mani Nagarajan, Sakthirajan Ramanathan, Jeyachandran Dhanapriya, Thanigachalam Dineshkumar, T Bala Subramaniyan, Natarajan Gopalakrishnan
BACKGROUND: Acute kidney injury (AKI) is one of the major determinants of graft survival in kidney transplantation (KTx). Renal Transplant recipients are more vulnerable to develop AKI than general population. AKI in the transplant recipient differs from community acquired, in terms of risk factors, etiology and outcome. Our aim was to study the incidence, risk factors, etiology, outcome and the impact of AKI on graft survival. METHODS: A retrospective analysis of 219 renal transplant recipients (both live and deceased donor) was done...
October 24, 2016: Renal Failure
I Dedinská, Ľ Laca, J Miklušica, D Kantárová, P Galajda, M Mokáň
BACKGROUND: New-onset diabetes mellitus after transplantation (NODAT) is a well-known complication of transplantation. OBJECTIVE: To determine the correlation between CMV infection and NODAT. METHODS: Retrospectively, we detected CMV replication (PCR) in every month after renal transplantation in the first 12 months of the procedure in a homogenous group of patients from the immunosuppression point of view. RESULTS: In 167 patients (64 with NODAT and 103 in the control group), the average amount of CMV viremia was not significantly different between the NODAT and the control group (p=0...
2016: International Journal of Organ Transplantation Medicine
Magdalena Jankowska, Abdul Rashid Qureshi, Peter Barany, Olof Heimburger, Peter Stenvinkel, Bengt Lindholm
AIM: Autosomal dominant polycystic kidney disease (ADPKD), a systemic disorder caused by mutation in genes encoding polycystins, has been reported to lead to metabolic derangements including new-onset diabetes mellitus after kidney transplantation. We analyzed markers of insulin resistance (IR), inflammation, nutritional status and insulin-like growth factor-1 (IGF-1) in end-stage renal disease (ESRD) patients with ADPKD and ESRD patients with other primary kidney diseases. METHODS: In a post hoc cross-sectional analysis in 254 non-diabetic CKD 5 patients starting on dialysis, glucose metabolism (insulin, IGF-1, homeostasis model assessment of IR, HOMA-IR), inflammation (high sensitivity C-reactive protein, interleukin-6, and tumor necrosis factor), nutritional status, and bone mineral density (BMD), were assessed...
September 22, 2016: Nephrology
Alireza Mehrnia, Thuy X Le, Tamer R Tamer, Suphamai Bunnapradist
Improving long-term transplant and patient survival is still an ongoing challenge in kidney transplant medicine. Our objective was to identify the subsequent risks of new-onset diabetes after transplant (NODAT) and acute rejection (AR) in the first year post-transplant in predicting mortality and transplant failure. A total of 4687 patients without preexisting diabetes (age 2-20 years, 2004-2010) surviving with a functioning transplant for longer than 1 year with at least one follow-up report were identified from the OPTN/UNOS database as of September 2014...
August 31, 2016: Pediatric Transplantation
D Cieniawski, P Miarka, E Ignacak, A Bętkowska-Prokop, M Waluś-Miarka, B Idzior-Waluś, M Kuźniewski, W Sułowicz
BACKGROUND: Patients who are receiving immunosuppressive treatment after kidney transplantation are at greater risk of developing new-onset diabetes after transplantation (NODAT). New biochemical markers that may contribute to a better assessment of the prognosis of renal failure for patients diagnosed with diabetes mellitus (DM) are needed. The aim of this study was to assess selected proinflammatory markers in patients after kidney transplantation depending on the prevalence of DM and to evaluate the predictive value of these cytokines...
June 2016: Transplantation Proceedings
Takahisa Hiramitsu, Manabu Okada, Kenta Futamura, Takayuki Yamamoto, Makoto Tsujita, Norihiko Goto, Shunji Narumi, Yoshihiko Watarai, Asami Takeda, Kenta Iwasaki, Kazuharu Uchida, Takaaki Kobayashi
The aim of this study is to evaluate the efficacy and safety of everolimus plus reduced-dose cyclosporine compared with mycophenolate mofetil plus standard-dose cyclosporine 5years after living donor kidney transplantation. Between March 2008 and August 2009, 24 living donor kidney transplantations were enrolled in a 2-year, multicenter, randomized phase 3 study (RAD001A1202 study). 24 recipients were randomly classified into two groups and closely observed for 5years. 13 recipients were administered steroid, reduced-dose cyclosporine, everolimus and basiliximab (EVR group)...
October 2016: International Immunopharmacology
Hoon Yu, Hyosang Kim, Chung Hee Baek, Seung Don Baek, Soomin Jeung, Duck Jong Han, Su-Kil Park
BACKGROUND: New-onset diabetes mellitus after transplantation (NODAT) is a serious complication following renal transplantation. The aim of this study was to identify the risk factors for the development of NODAT in Korean transplant patients. METHODS: Recipients who underwent living donor kidney transplantation between January 2009 and April 2012 at Asan Medical Center were reviewed. Diagnosis of NODAT was defined according to the American Diabetes Association criteria...
2016: BMC Nephrology
Dávid Ágoston Kovács, Volkert Al Huurman, Maciej Wojcicki, Darius Soonowala, Andrzej Baranski
Simultaneous pancreas-kidney transplant is currently standard therapy to achieve long-term insulin-free euglycemia in patients with type 1 diabetes mellitus and concomitant end-stage kidney failure. A patient with symptoms of encephalopathy caused by hyperammonemia and with new-onset iron deficiency anemia was admitted to our institution 20 months after a simultaneous pancreas-kidney transplant. Detailed screening did not reveal any specific cause for the hyperammonemia, and despite standard treatment, hyperammonemia did not resolve...
July 22, 2016: Experimental and Clinical Transplantation
I Dedinská, B Palkoci, J Miklušica, D Osinová, P Galajda, M Mokáň
AIMS: The metabolic syndrome developed after kidney transplantation is the result of several factors which are identical with the risk factors in normal population, however, also some factors typical for the transplanted patients-especially the effects of immunosuppressive therapy. MATERIAL AND METHODS: In the groupof 268 patients after kidney transplantation, which had no type 1 or type 2 diabetes mellitus before transplantation, we identified patients with metabolic syndrome(based on IDF criteria), 12 months from the kidney transplantation...
June 23, 2016: Diabetes & Metabolic Syndrome
J-H Chen, C-H Lee, C-M Chang, W-Y Yin
In kidney transplantation, obesity is associated with poorer graft survival and patient survival. Bariatric surgery may provide benefit for these patients, not only by inducing weight loss, but also via reduction of diabetes. We report a case of morbid obesity, poorly controlled new-onset diabetes mellitus, and gout after kidney transplantation that was treated with laparoscopic sleeve gastrectomy 3 years after kidney transplantation. After 1 year of follow-up, 76% excessive body weight loss was attained. No complications were noted...
April 2016: Transplantation Proceedings
S Ong, S-W Kang, Y-H Kim, T-H Kim, K-H Jeong, S-K Kim, Y-C Yoon, S-K Seo, J-Y Moon, S-H Lee, C-G Ihm, T-W Lee, J-H Chung
BACKGROUND: New-onset diabetes after transplantation (NODAT) is a serious metabolic complication that may follow renal transplantation. Matrix metalloproteinases (MMPs) contribute to insulin insufficiency and beta-cell dysfunction in a rat model. The MMP-2 concentrations were lower in patients with type 2 diabetes mellitus, and the plasma MMPs levels were related to diabetes. Similar to the pathogenesis of type 2 diabetes mellitus, insulin resistance and insulin secretion dysfunction occur in patients with the development of NODAT...
April 2016: Transplantation Proceedings
L M Lim, L F Kung, M C Kuo, H T Kuo
BACKGROUND: Mammalian target of rapamycin inhibitors (mTORi) play an essential role as novel immunosuppressive agents in kidney transplantation (KT). Treatment cessation usually occurs after adverse effects occur. We investigated the risk factors associated with withdrawal of mTORi in KT recipients and evaluated the outcomes related to the withdrawal. METHODS: The study enrolled KT recipients being followed up in a medical center in southern Taiwan from January 1999 through December 2014...
April 2016: Transplantation Proceedings
Shaikha Alshamsi, Nawal Basri, Ahmed Flaiw, Ghormullah Ghamdi, Fayez Hejaili, Faissal A M Shaheen, Foud Sheayria, Maha Jaradat, Abdulla Al Sayyari
OBJECTIVES: The study objective was to investigate the predictability and risk factors for the development of new-onset type 2 diabetes mellitus after transplant in the Saudi population. MATERIALS AND METHODS: This was a retrospective observational cohort study in adult kidney transplant recipients who developed new-onset type 2 diabetes mellitus after transplant. Patients with and without new-onset type 2 diabetes mellitus after transplant were compared for demographic factors, blood glucose levels at 4-hour intervals for 24 hours after transplant, and serum creatinine levels at 6 and 12 months after transplant...
June 2016: Experimental and Clinical Transplantation
Wisit Cheungpasitporn, Charat Thongprayoon, Priya Vijayvargiya, Pimjai Anthanont, Stephen B Erickson
OBJECTIVES: New-onset diabetes after kidney transplantation (NODAT) is associated with both renal allograft failure and increased rates of mortality. The objective of this meta-analysis was to evaluate the risk for NODAT in patients with autosomal dominant polycystic kidney disease (ADPKD). METHODS: A literature search was performed using MEDLINE, EMBASE and Cochrane Database of Systematic Reviews from inception through July 2015. Studies that reported relative risks, odd ratios or hazard ratios comparing the risk for NODAT in patients with ADPKD were included...
May 13, 2016: Canadian Journal of Diabetes
Karel Krejci, Josef Zadrazil, Eva Lackova, Zuzana Zilinska, Robert Roland, Ivana Dedinska
BACKGROUND AND AIMS: The CONCERTO study results showing the beneficial effects of conversion from cyclosporine to tacrolimus prolonged-release (tacrolimus PR) in stabilised patients after kidney transplantation, were first published in 2011. This communication describes our first experience of conversion from cyclosporine to tacrolimus PR in stabilised kidney transplant patients. The aim was to determine whether it could be used in routine clinical practice in the Czech and Slovak Republics...
September 2016: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
Xuerong Wen, Michael Jin Casey, Alfonso H Santos, Abraham Hartzema, Karl L Womer
The performance of belatacept in a real clinical setting has not been reported. A retrospective cohort study was conducted using registry data comparing one-year clinical outcomes between belatacept- and tacrolimus-treated adult kidney transplant recipients (KTR) from 6.1.2011 through 12.1.2014. Of 50 244 total patients, 417 received belatacept+tacrolimus, 458 received belatacept alone, and 49 369 received tacrolimus alone at discharge. In the overall study cohort, belatacept alone was associated with a higher risk for one-year acute rejection, with highest rates associated with non-lymphocyte depleting (LD) induction (aHR: 2...
May 3, 2016: American Journal of Transplantation
E A Cohen, D Mulligan, S Kulkarni, E M Tichy
Benefits of belatacept-based immunosuppressive regimens in human immunodeficiency virus (HIV)-positive renal transplant recipients include avoidance of drug interactions between calcineurin inhibitors and highly active antiretroviral agents and decreased likelihood or severity of nonimmune toxicities such as new-onset diabetes after transplant, hyperlipidemia and hypertension. We report a successful case of de novo belatacept at >18 mo from transplant in an HIV-positive black man aged 50 years who received his first transplant from a living related kidney donor...
September 2016: American Journal of Transplantation
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