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NDT Advance Access published online on March 29, 2007
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfm011
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© The Author [2007]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Diabetes mellitus after kidney transplantation: a French multicentre observational study

Nassim Kamar1, Christophe Mariat2, Michel Delahousse3, Jacques Dantal4, Azmi Al Najjar5, Elisabeth Cassuto6, Nicole Lefrançois7, Olivier Cointault1, Guy Touchard8, Florence Villemain9, Fabienne Di Giambattista10, Pierre-Yves Benhamou11 on behalf of the Diapason Study Group

1Néphrologie, Dialyse et Transplantation, CHU Rangueil, Toulouse, 2Néphrologie, Dialyse et Transplantation, Hôpital Nord, Saint-Etienne, 3Néphrologie, Dialyse et Transplantation, Hôpital Foch, Suresnes, 4Néphrologie, Dialyse et Transplantation, Hôpital Hôtel-Dieu, Nantes, France, 5Néphrologie, Dialyse et Transplantation, Hôpital Bretonneau, Tours, 6Néphrologie, Dialyse et Transplantation, Hôpital Pasteur, Nice, 7Néphrologie, Dialyse et Transplantation, Hôpital Edouard Herriot, 8Néphrologie, Dialyse et Transplantation, CHU La Milétrie, Poitiers, 9Néphrologie, Dialyse et Transplantation, CHU d’Angers, Angers, 10Novartis Pharma S.A.S., Rueil-Malmaison and 11Endocrinologie Diabétologie Nutrition, CHU de Grenoble, Grenoble, France

Correspondence and offprint requests to: Nassim Kamar, MD, PhD, Service de Néphrologie, Dialyse et Transplantation, CHU Rangueil, 1 avenue Jean Poulhès, TSA 50032, 31059 Toulouse Cedex 9, France. Email: kamar.n{at}chu-toulouse.fr



  Abstract

Background. New-onset diabetes mellitus (NODM)—a common complication of kidney transplantation—is associated with increases in graft loss, morbidity and mortality.

Methods. This is a purely observational study of 527 patients taking a calcineurin inhibitor (CNI), based on data collected at a single routine visit 6–24 months after kidney transplantation. Diabetes was defined according to ADA/WHO guidelines.

Results. The mean age of the patients was 47.2 years and 61.1% were men; 49.5% were receiving cyclosporine microemulsion (CsA-ME) and 50.5% tacrolimus (Tac). NODM developed in 7.0% after a median interval of 1.6 months. In CsA-ME-treated patients, the unadjusted cumulative risks of NODM were 5.5% and 8.4% at 1- and 2-year post-transplantation, while in Tac-treated patients, the risks were respectively 17.4% and 21%. Four independent risk factors (RFs) were identified by multivariate analysis: maximum lifetime body mass index >25 [odds ratio (OR) = 5.1], pre-transplantation impaired fasting glucose (OR = 4.7), hepatitis C status (OR = 4.7) and Tac vs CsA-ME treatment (OR = 3.0).

Conclusions. NODM is associated with certain RFs present prior to kidney transplantation, and with treatment with Tac as opposed to CsA-ME.

Keywords: calcineurin inhibitors; hepatitis C virus; renal transplantation; new onset diabetes mellitus; pre-transplantation impaired fasting glucose

Received for publication: 3.10.06
Accepted in revised form: 5. 1.07


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