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O P Prajapati, A K Verma, R K Sharma, M Sabaretnam
We conducted a prospective study (between November 2013 and January 2015) to identify "foot at risk" in the diabetic renal transplant patients at a Tertiary Care Hospital in India. Patients (151) were divided into three groups: diabetic transplant recipients (n = 42), new onset diabetes after transplantation (NODAT) (n = 59), and controls (nondiabetic renal transplant recipients) (n = 50). Foot neuropathy and vasculopathy were assessed by standard methods. Patients with "at risk" feet were given foot care advice...
September 2016: Saudi Journal of Kidney Diseases and Transplantation
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
Ester García-Casarrubios, Carlos de Moura, Ana I Arroba, Nuria Pescador, María Calderon-Dominguez, Laura Garcia, Laura Herrero, Dolors Serra, Susana Cadenas, Flavio Reis, Eugenia Carvalho, Maria Jesus Obregon, Ángela M Valverde
New onset diabetes after transplantation (NODAT) is a metabolic disorder that affects 40% of patients on immunosuppressive agent (IA) treatment, such as rapamycin (also known as sirolimus). IAs negatively modulate insulin action in peripheral tissues including skeletal muscle, liver and white fat. However, the effects of IAs on insulin sensitivity and thermogenesis in brown adipose tissue (BAT) have not been investigated. We have analyzed the impact of rapamycin on insulin signaling, thermogenic gene-expression and mitochondrial respiration in BAT...
September 26, 2016: Biochimica et Biophysica Acta
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
Mengjuan Xue, Chaoyang Lv, Xianying Chen, Jing Liang, Chenhe Zhao, Yao Zhang, Xiaowu Huang, Qiman Sun, Ting Wang, Jian Gao, Jian Zhou, Mingxiang Yu, Jia Fan, Xin Gao
AIM: To investigate whether donor liver steatosis increases the incidence of new-onset diabetes after transplantation (NODAT) in liver transplant recipients. METHODS: We retrospectively analyzed liver transplant recipients at our hospital from April 2001 to December 2014. The final analysis involved 763 patients. The cumulative incidence of NODAT at 1, 3, 5, and 10 years after liver transplantation was investigated. Further, according to the findings of donor liver biopsy before transplantation, patients were divided into steatotic and non-steatotic donor liver groups, and NODAT incidence was compared between these groups...
August 10, 2016: Journal of Diabetes Investigation
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
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
Oluwatoyin Bamgbola
Among other factors, sophistication of immunosuppressive (IS) regimen accounts for the remarkable success attained in the short- and medium-term solid organ transplant (SOT) survival. The use of steroids, mycophenolate mofetil and calcineurin inhibitors (CNI) have led to annual renal graft survival rates exceeding 90% in the last six decades. On the other hand, attrition rates of the allograft beyond the first year have remained unchanged. In addition, there is a persistent high cardiovascular (CV) mortality rate among transplant recipients with functioning grafts...
June 2016: Therapeutic Advances in Endocrinology and Metabolism
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
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
Allon Kahn, Justin A Reynolds, Harini A Chakkera, Bashar A Aqel, Thomas J Byrne, David D Douglas, Adyr A Moss, Hugo E Vargas, Elizabeth J Carey
BACKGROUND: Liver transplant recipients are at increased risk of metabolic complications, including new-onset diabetes mellitus after transplantation (NODAT) and post-transplant metabolic syndrome (PTMS), both of which are associated with decreased patient survival. We prospectively monitored traditional and novel metabolic parameters in nondiabetic liver transplantation (LT) candidates to determine their role in detecting these conditions. METHODS: Nondiabetic adults undergoing initial LT were prospectively identified...
August 2016: Metabolic Syndrome and related Disorders
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
Ayse Sinangil, Vedat Celik, Soykan Barlas, Tamer Sakaci, Yener Koc, Taner Basturk, Emin Baris Akin, Tevfik Ecder
AIM: Hypomagnesemia is a frequent finding in kidney transplant patients and plays a causal role in insulin resistance and diabetes. The aim of this study was to investigate whether the pretransplant magnesium (Mg) level is a risk factor for the development of new-onset diabetes after kidney transplantation (NODAT) and the presence of relationship between pretransplant hypomagnesemia and the development period of NODAT. METHODS: Four hundred and nineteen nondiabetic renal transplant recipients were evaluated retrospectively...
March 2016: Progress in Transplantation
Tess Montada-Atin, Diana Choi, Minna Woo, Ravi Retnakaran, Michael Huang, G V Ramesh Prasad, Jeffrey S Zaltzman
BACKGROUND: Studies have shown that erythropoietin-stimulating agents (ESAs) protect mice against the development of diabetes through direct effects on pancreatic ß cells. However, the effect of ESAs on the incidence of diabetes in humans has not been well studied. It is unknown whether exposure to ESAs is associated with a reduced incidence of new-onset diabetes after transplant (NODAT). OBJECTIVE: The objective of this study is to examine the relationship between ESA exposure post-renal transplant and the development of NODAT...
2016: Canadian Journal of Kidney Health and Disease
Amisha Wallia, Vidhya Illuri, Mark E Molitch
Patients who undergo solid organ transplantation may have preexisting diabetes mellitus (DM), develop new-onset DM after transplantation (NODAT), or have postoperative hyperglycemia that resolves shortly after surgery. Although insulin is usually used to control hyperglycemia in the hospital, following discharge most of the usual diabetes oral and parenteral medications can be used in treatment. However, when there are comorbidities such as impaired kidney or hepatic function, or heart disease, special precautions may be necessary...
May 2016: Medical Clinics of North America
S Chand, A J McKnight, S Shabir, W Chan, J A McCaughan, A P Maxwell, L Harper, R Borrows
INTRODUCTION: Despite excellent first year outcomes in kidney transplantation, there remain significant long-term complications related to new-onset diabetes after transplantation (NODAT). The purpose of this study was to validate the findings of previous investigations of candidate gene variants in patients undergoing a protocolised, contemporary immunosuppression regimen, using detailed serial biochemical testing to identify NODAT development. METHODS: One hundred twelve live and deceased donor renal transplant recipients were prospectively followed-up for NODAT onset, biochemical testing at days 7, 90, and 365 after transplantation...
June 2016: BBA Clinical
Wisit Cheungpasitporn, Charat Thongprayoon, Tasma Harindhanavudhi, Peter J Edmonds, Stephen B Erickson
BACKGROUND: New-onset diabetes after kidney transplantation (NODAT) is associated with both renal allograft failure and increased mortality. The objective of this meta-analysis was to evaluate the risk of NODAT in patients with hypomagnesemia. METHODS: A literature search was performed using MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews from inception through May, 2015. Studies that reported relative risks, odd ratios or hazard ratios comparing the risk of NODAT in patients with hypomagnesemia were included...
May 2016: Endocrine Research
Dominika Goldmannova, David Karasek, Ondrej Krystynik, Josef Zadrazil
BACKGROUND AND AIM: Diabetes mellitus is a very common metabolic disease with a rising incidence. It is both a leading cause of chronic renal disease and one of the most serious comorbidities in renal transplant recipients. New-onset diabetes after renal transplantation (NODAT) is associated with poor graft function, higher rates of cardiovascular complications and a poor prognosis. The aim of this paper is to review current knowledge of NODAT including risk factors, diagnosis and management...
June 2016: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
Shoichiro Kanda, Naoya Morisada, Naoto Kaneko, Tomoo Yabuuchi, Yuri Nawashiro, Norimasa Tada, Kei Nishiyama, Takayuki Miyai, Noriko Sugawara, Kiyonobu Ishizuka, Hiroko Chikamoto, Yuko Akioka, Kazumoto Iijima, Motoshi Hattori
CAKUT are the most frequent causes of ESRD in children. Mutations in the gene encoding HNF1B, a transcription factor involved in organ development and maintenance, cause a multisystem disorder that includes CAKUT, diabetes, and liver dysfunction. Here, we describe the case of a patient with renal hypodysplasia who developed NODAT presenting with liver dysfunction. The NODAT was initially thought to be steroid and FK related. However, based on the patient's clinical features, including renal hypodysplasia and recurrent elevations of transaminase, screening for an HNF1B mutation was performed...
May 2016: Pediatric Transplantation
Hung-Tien Kuo, Erik Lum, Paul Martin, Suphamai Bunnapradist
The effects of diabetic status and acute rejection (AR) on liver transplant outcomes are largely unknown. We studied 13,736 liver recipients from the United Network for Organ Sharing/Organ Procurement Transplant Network database who underwent transplantation between 2004 and 2007 with a functioning graft for greater than 1 year. The association of pretransplant diabetes mellitus (PDM), new-onset diabetes after transplant (NODAT), and AR rates on allograft failure, all-cause mortality, and cardiovascular mortality were determined...
June 2016: Liver Transplantation
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