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Daohua Shi, Tiancheng Xie, Jie Deng, Peiguang Niu, Weizhen Wu
PURPOSE: We intend to investigate the association between tacrolimus-induced new-onset diabetes after transplantation (NODAT) and polymorphisms of CYP3A4, CYP3A5, ATP-binding cassette transporter sub-family C member 8 (ABCC8), and glucokinase (GCK) in renal transplant recipients. METHODS: Polymorphisms of CYP3A4 *18B, CYP3A5 *3, ABCC8 T-3C, and GCK G-30A were genotyped in 169 renal transplant recipients. Trough concentrations of tacrolimus were detected by an ELISA kit...
March 15, 2018: European Journal of Clinical Pharmacology
Leyla J Aouad, Philip Clayton, Kate R Wyburn, David M Gracey, Steven J Chadban
BACKGROUND: The evolution of glycaemic changes after kidney transplantation has not been described. We prospectively examined glycaemic control and variability over time from transplantation using continuous glucose monitoring(CGM). METHOD: CGM devices were fitted for 3-5 days at time of transplant, month 3 and month 6 posttransplant. Indices of glucose control (mean glucose, percent time in hyperglycemic range and GRADE score) and variability were calculated. An OGTT was performed at month 3...
February 28, 2018: Transplantation
Alon Grossman, Irit Ayalon-Dangur, Lisa Cooper, Tzippy Shohat, Ruth Rahamimov, Eytan Mor, Anat Gafter-Gvili
PURPOSE: Anemia has been reported to be associated with diabetes, but the association between new-onset diabetes after transplantation (NODAT) and anemia has not been reported. METHODS: Patients who underwent kidney transplantation and did not have diabetes prior to transplantation were included in this study. Hemoglobin levels and the prevalence of anemia (hemoglobin <12 g/dL in females and <13 g/dL in males) were evaluated at three time points (prior to transplantation, 6 months following transplantation or 1 month before the development of NODAT, 2 years following transplantation, or following the development of NODAT) and were compared between those who developed NODAT and those who did not...
January 4, 2018: Endocrine Research
Saba Samad Memon, Nikhil Tandon, Sandeep Mahajan, V K Bansal, Asuri Krishna, Arunkumar Subbiah
Objectives: This study aimed to determine the prevalence of immediate posttransplant hyperglycemia and new onset diabetes after renal transplantation (NODAT). It also aims at answering whether posttransplant hyperglycemia per se is a risk factor for future development of NODAT. Methods: A retrospective study was conducted among patients undergoing kidney transplantation under a single surgical unit in a tertiary care hospital in the past 5 years. All known patients with diabetes were excluded from the study...
November 2017: Indian Journal of Endocrinology and Metabolism
Núria Saigi-Morgui, Lina Quteineh, Pierre-Yves Bochud, Severine Crettol, Zoltán Kutalik, Nicolas J Mueller, Isabelle Binet, Christian Van Delden, Jürg Steiger, Paul Mohacsi, Jean-Francois Dufour, Paola M Soccal, Manuel Pascual, Chin B Eap
New Onset Diabetes after Transplantation (NODAT) is a frequent complication after solid organ transplantation, with higher incidence during the first year. Several clinical and genetic factors have been described as risk factors of Type 2 Diabetes (T2DM). Additionally, T2DM shares some genetic factors with NODAT. We investigated if three genetic risk scores (w-GRS) and clinical factors were associated with NODAT and how they predicted NODAT development 1 year after transplantation. In both main (n = 725) and replication (n = 156) samples the clinical risk score was significantly associated with NODAT (ORmain : 1...
December 27, 2017: Pharmacogenomics Journal
F P Tillmann, M Schmitz, L C Rump, I Quack
BACKGROUND: This study aimed to evaluate the impact of 5 mg of prednisolone/day on HbA1c levels and its association with the development of pre-diabetes and new-onset diabetes mellitus (NODAT) in non-diabetic first renal transplant recipients on long-term follow-up. METHODS: Four hundred patients were analysed on an average of 4.1 ± 3.0 years after successful transplantation: 96 (24%) were steroid-free and 304 (76%) treated with 5 mg of prednisolone/day combined with cyclosporine A (CsA) or tacrolimus (Tac) as part of their immunosuppressive protocol...
December 2, 2017: International Urology and Nephrology
Analaura Centenaro, Elis F Pedrollo, Bruna B Nicoletto, Roberto C Manfro, Luiz Felipe S Gonçalves, Cristiane B Leitão, Gabriela C Souza
OBJECTIVE: To verify the association of dietary patterns and dietary components with new-onset diabetes mellitus after transplantation (NODAT). DESIGN: Cross-sectional study. SUBJECTS: Adult kidney transplant recipients, without history of diabetes before transplantation, who received a kidney transplant and were followed up for at least 1 year. One hundred and sixteen subjects recruited between January 2013 and August 2014. Diagnosis of NODAT was established according to the American Diabetes Association criteria for type 2 diabetes...
March 2018: Journal of Renal Nutrition
Antônio R Andrade, Paulo L Bittencourt, Liana Codes, Maria A Evangelista, Alessandra O Castro, Ney Boa Sorte, Carolina G Almeida, Jorge A Bastos, Helma P Cotrim
BACKGROUND & AIMS: Non-alcoholic fatty liver disease (NAFLD) is an emerging cause of graft dysfunction after liver transplantation (LT) frequently related to the development of new onset diabetes after LT (NODAT). This study was undertaken to evaluate the frequencies of NODAT and NAFLD after LT, to investigate their major risk factors and the impact of de novo or recurrent NAFLD in graft function. MATERIAL AND METHODS: 119 patients submitted to LT were prospectively evaluated...
October 16, 2017: Annals of Hepatology
Alfonso H Santos, Chao Chen, Michael J Casey, Karl L Womer, Xuerong Wen
Background: This study aimed to analyze adult kidney transplant recipients (KTRs) for the risk of new-onset diabetes after transplantation (NODAT) associated with viral serologies and immunosuppression regimens [tacrolimus (Tac) + mycophenolate (MPA), cyclosporine (CSA) + MPA, sirolimus (SRL) + MPA, SRL + CSA or SRL +Tac]. Methods: Cox regression models were used to examine the risk of NODAT in the first posttransplant year associated with: (i) CSA + MPA, SRL + MPA, SRL + MPA or SRL + Tac versus reference, Tac + MPA; (ii) pretransplant viral serology [+ or -; hepatitis B core (HBc), hepatitis C (HCV), cytomegalovirus (CMV) or Epstein Barr Virus (EBV)]; and (iii) interactions between immunosuppression regimens and the viral serology found significant in the main analysis...
October 16, 2017: Nephrology, Dialysis, Transplantation
Saurabh Baheti, Prachi Singh, Yun Zhang, Jared Evans, Michael D Jensen, Virend K Somers, Jean-Pierre A Kocher, Zhifu Sun, Harini A Chakkera
AIM: New-onset diabetes after kidney transplant (NODAT) adversely impacts kidney allograft and patient survival. Epigenetic alterations in adipose tissue like DNA methylation may play a contributory role. METHODS: Adipose tissue DNA of the patients with NODAT and their age, sex and BMI matched controls (nine each) were sequenced by reduced representation bisulfite sequencing. Differentially methylated CpGs (DMCs) and differentially methylated regions (DMRs) were studied...
October 2, 2017: Epigenomics
S C Alagbe, A Voster, R Ramesar, C R Swanepoel
BACKGROUND: The outcome of renal transplantation depends on achieving effective immunosuppression while minimising the consequences of such treatment. The occurrence of new-onset diabetes in the post-transplant period has been associated with several risk factors including some immunosuppressive medication. Better understanding of the clinical and genetic risk factors associated with new-onset diabetes after transplant (NODAT) could enable risk stratification of patients in the pre-transplant period, with the goal of applying measures that will reduce the incidence...
August 25, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Padmanabhan Guruprasad, Kamal Kishore, Sandeep Mahajan, Sandeep Aggarwal
AIM: Renal transplantation is the treatment of choice for end-stage renal disease patients. Renal transplant recipients, however, have to be on lifelong therapy with immunosuppressants, which are associated with a number of adverse events (AEs). The safety profile of these immunosuppressants is not clear with respect to the Indian population. This study was conducted to find the frequency and pattern of all AEs experienced by Indian renal transplant recipients during the initial 3 months posttransplantation...
July 2017: Perspectives in Clinical Research
Y Kim, A D Jung, V K Dhar, J S Tadros, D P Schauer, E P Smith, D J Hanseman, M C Cuffy, R R Alloway, A R Shields, S A Shah, E S Woodle, T S Diwan
Morbid obesity is a barrier to kidney transplantation due to inferior outcomes, including higher rates of new-onset diabetes after transplantation (NODAT), delayed graft function (DGF), and graft failure. Laparoscopic sleeve gastrectomy (LSG) increases transplant eligibility by reducing BMI in kidney transplant candidates, but the effect of surgical weight loss on posttransplantation outcomes is unknown. Reviewing single-center medical records, we identified all patients who underwent LSG before kidney transplantation from 2011-2016 (n = 20)...
August 14, 2017: American Journal of Transplantation
Ragnhild Heier Skauby, Anna Bjerre, Ingjerd Sæves, Nils Tore Vethe, Sara Bremer, Anja Svarstad, Stein Bergan
BACKGROUND: Prednisolone is a standard component of immunosuppressive protocols in renal transplantation (Tx) and despite standardized treatment regimens, adverse side effects are still frequent. The aim of this study was to characterize the pharmacokinetics of prednisolone and prednisone in pediatric renal transplant recipients in the first 52 weeks post Tx, to describe the relationship between prednisolone and prednisone, and to investigate a possible relationship between the development of new-onset diabetes after Tx (NODAT) and glucocorticoid exposure...
October 2017: Therapeutic Drug Monitoring
L Cooper, N Oz, G Fishman, T Shohat, R Rahamimov, E Mor, H Green, A Grossman
OBJECTIVE: Clinical outcomes in individuals with new onset diabetes after transplantation (NODAT) and the optimal treatment for this complication are poorly characterized. This study was intended to better define these issues. METHODS: Patients who underwent kidney transplantation and did not have diabetes prior to transplantation were included in the study. Clinical outcomes were compared between those who developed NODAT and those who did not. In those who developed NODAT, oral therapy was compared with insulin based therapy...
July 21, 2017: Diabetes/metabolism Research and Reviews
Jianming Zheng, Wenli Song
Alemtuzumab (ALEM) is widely used as an induction therapy for organ transplantation, and numerous randomized controlled trials (RCTs) have been published to evaluate its efficacy and safety in kidney transplantation as compared with antithymocyte globulin (ATG). The purpose of this study was to compare the benefits and safety of ALEM with those of ATG for induction therapy.A systematic literature search in three electronic databases, including PubMed, EmBase, and Cochrane Library, since inception through October 2016, was conducted to identify potential RCTs for inclusion...
July 2017: Medicine (Baltimore)
Florian Kälble, Jörg Seckinger, Matthias Schaier, Christian Morath, Vedat Schwenger, Martin Zeier, Claudia Sommerer
BACKGROUND: Mammalian target of rapamycin inhibitors (mToRi) allow calcineurin inhibitor (CNI) sparing therapy in renal transplant recipients with possible beneficial effects on the long-term allograft function and cardiovascular risk. The influence of mToRi on glucose metabolism is still under discussion. METHODS: In a retrospective analysis, renal allograft recipients switched from a cyclosporine A (CsA) to an everolimus (EVR)-based immunosuppression in the first year after transplantation were compared with patients on continued CsA treatment...
June 5, 2017: Clinical Transplantation
Michele F Eisenga, Dorien M Zelle, John H Sloan, Carlo A J M Gaillard, Stephan J L Bakker, Robin P F Dullaart
OBJECTIVE: New-onset diabetes after transplantation (NODAT) is a major complication in renal transplant recipients (RTRs). Cholesterol metabolism has been linked to diabetes development. Proprotein convertase subtilisin/kexin type 9 (PCSK9) is crucial in LDL receptor regulation. Its association with NODAT is unknown. We prospectively determined the association between serum PCSK9 levels and NODAT development and then with all-cause mortality, cardiovascular mortality, and renal graft failure...
May 1, 2017: Diabetes Care
Oscar Kenneth Serrano, Raja Kandaswamy, Kristen Gillingham, Srinath Chinnakotla, Ty B Dunn, Erik Finger, William Payne, Hassan Ibrahim, Aleksandra Kukla, Richard Spong, Naim Issa, Timothy L Pruett, Arthur Matas
BACKGROUND: Short- and intermediate-term results have been reported after rapid discontinuation of prednisone (RDP) in kidney transplant recipients. Yet there has been residual concern about late graft failure in the absence of maintenance prednisone. METHODS: From October 1, 1999, through June 1, 2015, we performed a total of 1553 adult first and second kidney transplants-1021 with a living donor, 532 with a deceased donor-under our RDP protocol. We analyzed the 15-year actuarial overall patient survival (PS), graft survival (GS), death-censored GS (DCGS), and acute rejection-free survival (ARFS) rates for RDP compared with historical controls on maintenance prednisone...
October 2017: Transplantation
Ayse Sinangil, Vedat Celik, Soykan Barlas, Yener Koc, Taner Basturk, Tamer Sakaci, Emin Baris Akin, Tevfik Ecder
AIM: New-onset diabetes after transplantation (NODAT) is a frequent metabolic complication and is considered a risk factor for patients undergoing renal transplant. The aim of this study was to evaluate the incidence and developing duration of new-onset diabetes after transplant (NODAT) and influencing factors. METHODS: All patients' data was investigated retrospectively. Diabetics, follow-up period<6 months, age<18years were excluded. Demographic, clinical and laboratory data was recorded...
March 2017: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
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