NDT Advance Access published online on March 8, 2008
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfn052
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© The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org
New-onset diabetes after transplantation—should it be a factor in choosing an immunosuppressant regimen for kidney transplant recipients?
Department of Renal Medicine, Royal Prince Alfred Hospital, NSW 2050, Australia
Correspondence and offprint requests to: Steven Chadban, Department of Renal Medicine, Royal Prince Alfred Hospital, Missenden Road, Camperdown, NSW 2050, Australia. E-mail: steve.chadban@sswahs.nsw.gov.au, steve.chadban@email.cs.nsw.gov.au
Keywords: cyclosporin; diabetes; kidney transplant; outcome; tacrolimus
| The first 10% of the full text of this article appears below. |
The capacity to prevent acute rejection has been paramount in the minds of most clinicians in selecting an immunosuppressive strategy for kidney transplant recipients. This was certainly reasonable during the 1970s, 1980s and 1990s, as acute rejection was a common cause of graft loss. As efficacy improved over that period of time, rates of acute rejection fell and 1-year graft survival surpassed 90%. Although rates of graft loss beyond the first year remained unchanged, the reductions in early graft loss produced equal improvements in 5- and 10-year graft survival [1].
Since the 1990s, rates of acute rejection have continued to fall; however, this has not been associated with further improvements in short- or long-term graft survival [2,3]. One reason is that acute rejection is no longer a major contributor to graft loss,