Analysis of risk factors and establishment of a risk prediction model for post-transplant diabetes mellitus after kidney transplantation
Introduction: Post-transplant diabetes mellitus (PTDM) is a known side effect in transplant recipients administered immunosuppressant drugs, such as tacrolimus. This study aimed to investigate the risk factors related to PTDM, and establish a risk prediction model for PTDM. In addition, we explored...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-08-01
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| Series: | Saudi Pharmaceutical Journal |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1319016422001463 |
| _version_ | 1818023384068390912 |
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| author | Fang Cheng Qiang Li Jinglin Wang Zhendi Wang Fang Zeng Yu Zhang |
| author_facet | Fang Cheng Qiang Li Jinglin Wang Zhendi Wang Fang Zeng Yu Zhang |
| author_sort | Fang Cheng |
| collection | DOAJ |
| description | Introduction: Post-transplant diabetes mellitus (PTDM) is a known side effect in transplant recipients administered immunosuppressant drugs, such as tacrolimus. This study aimed to investigate the risk factors related to PTDM, and establish a risk prediction model for PTDM. In addition, we explored the effect of PTDM on the graft survival rate of kidney transplantation recipients. Methods: Patients with pre-diabetes mellitus before kidney transplant were excluded, and 495 kidney transplant recipients were included in our study, who were assigned to the non-PTDM and PTDM groups. The cumulative incidence was calculated at 3 months, 6 months, 1 year, 2 years, and 3 years post-transplantation. Laboratory tests were performed and the tacrolimus concentration, clinical prognosis, and adverse reactions were analyzed. Furthermore, binary logistic regression analysis was used to identify the independent risk factors of PTDM. Results: Age ≥ 45 years (adjusted odds ratio [aOR] 2.25, 95% confidence interval [CI] 1.14–3.92; P = 0.015), body mass index (BMI) > 25 kg/m2 (aOR 3.12, 95% CI 2.29–5.43, P < 0.001), tacrolimus concentration > 10 ng/mL during the first 3 months post-transplantation (aOR 2.46, 95%CI 1.41–7.38; P < 0.001), transient hyperglycemia (aOR 4.53, 95% CI 1.86–8.03; P < 0.001), delayed graft function (DGF) (aOR 1.31, 95% CI 1.05–2.39; P = 0.019) and acute rejection (aOR 2.16, 95% CI 1.79–4.69; P = 0.005) were identified as independent risk factors of PTDM. The PTDM risk prediction model was developed by including the above six risk factors, and the area under the receiver operating characteristic curve was 0.916 (95% CI 0.862–0.954, P < 0.001). Furthermore, the cumulative graft survival rate was significantly higher in the non- PTDM group than in the PTDM group. Conclusions: Risk factors related to PTDM were age ≥ 45 years, BMI > 25 kg/m2, tacrolimus concentration > 10 ng/mL during the first 3 months post-transplantation, transient hyperglycemia, DGF and acute rejection. |
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| format | Article |
| id | doaj.art-adf20ac5597d49ce98c363a107cade2e |
| institution | Directory Open Access Journal |
| issn | 1319-0164 |
| language | English |
| last_indexed | 2024-12-10T03:43:27Z |
| publishDate | 2022-08-01 |
| publisher | Elsevier |
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| series | Saudi Pharmaceutical Journal |
| spelling | doaj.art-adf20ac5597d49ce98c363a107cade2e2022-12-22T02:03:30ZengElsevierSaudi Pharmaceutical Journal1319-01642022-08-0130810881094Analysis of risk factors and establishment of a risk prediction model for post-transplant diabetes mellitus after kidney transplantationFang Cheng0Qiang Li1Jinglin Wang2Zhendi Wang3Fang Zeng4Yu Zhang5Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Hubei Province Clinical Research Center for Precision Medicine for Critical Illness, Wuhan 430022, ChinaDepartment of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Hubei Province Clinical Research Center for Precision Medicine for Critical Illness, Wuhan 430022, ChinaDepartment of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Hubei Province Clinical Research Center for Precision Medicine for Critical Illness, Wuhan 430022, ChinaDepartment of Urology Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, ChinaDepartment of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Hubei Province Clinical Research Center for Precision Medicine for Critical Illness, Wuhan 430022, China; Corresponding authors at: Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; Hubei Province Clinical Research Center for Precision Medicine for Critical Illness, Wuhan 430022, China; Corresponding authors at: Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.Introduction: Post-transplant diabetes mellitus (PTDM) is a known side effect in transplant recipients administered immunosuppressant drugs, such as tacrolimus. This study aimed to investigate the risk factors related to PTDM, and establish a risk prediction model for PTDM. In addition, we explored the effect of PTDM on the graft survival rate of kidney transplantation recipients. Methods: Patients with pre-diabetes mellitus before kidney transplant were excluded, and 495 kidney transplant recipients were included in our study, who were assigned to the non-PTDM and PTDM groups. The cumulative incidence was calculated at 3 months, 6 months, 1 year, 2 years, and 3 years post-transplantation. Laboratory tests were performed and the tacrolimus concentration, clinical prognosis, and adverse reactions were analyzed. Furthermore, binary logistic regression analysis was used to identify the independent risk factors of PTDM. Results: Age ≥ 45 years (adjusted odds ratio [aOR] 2.25, 95% confidence interval [CI] 1.14–3.92; P = 0.015), body mass index (BMI) > 25 kg/m2 (aOR 3.12, 95% CI 2.29–5.43, P < 0.001), tacrolimus concentration > 10 ng/mL during the first 3 months post-transplantation (aOR 2.46, 95%CI 1.41–7.38; P < 0.001), transient hyperglycemia (aOR 4.53, 95% CI 1.86–8.03; P < 0.001), delayed graft function (DGF) (aOR 1.31, 95% CI 1.05–2.39; P = 0.019) and acute rejection (aOR 2.16, 95% CI 1.79–4.69; P = 0.005) were identified as independent risk factors of PTDM. The PTDM risk prediction model was developed by including the above six risk factors, and the area under the receiver operating characteristic curve was 0.916 (95% CI 0.862–0.954, P < 0.001). Furthermore, the cumulative graft survival rate was significantly higher in the non- PTDM group than in the PTDM group. Conclusions: Risk factors related to PTDM were age ≥ 45 years, BMI > 25 kg/m2, tacrolimus concentration > 10 ng/mL during the first 3 months post-transplantation, transient hyperglycemia, DGF and acute rejection.http://www.sciencedirect.com/science/article/pii/S1319016422001463Kidney transplantationPost-transplant diabetes mellitusRisk factorsTacrolimusGraft loss |
| spellingShingle | Fang Cheng Qiang Li Jinglin Wang Zhendi Wang Fang Zeng Yu Zhang Analysis of risk factors and establishment of a risk prediction model for post-transplant diabetes mellitus after kidney transplantation Saudi Pharmaceutical Journal Kidney transplantation Post-transplant diabetes mellitus Risk factors Tacrolimus Graft loss |
| title | Analysis of risk factors and establishment of a risk prediction model for post-transplant diabetes mellitus after kidney transplantation |
| title_full | Analysis of risk factors and establishment of a risk prediction model for post-transplant diabetes mellitus after kidney transplantation |
| title_fullStr | Analysis of risk factors and establishment of a risk prediction model for post-transplant diabetes mellitus after kidney transplantation |
| title_full_unstemmed | Analysis of risk factors and establishment of a risk prediction model for post-transplant diabetes mellitus after kidney transplantation |
| title_short | Analysis of risk factors and establishment of a risk prediction model for post-transplant diabetes mellitus after kidney transplantation |
| title_sort | analysis of risk factors and establishment of a risk prediction model for post transplant diabetes mellitus after kidney transplantation |
| topic | Kidney transplantation Post-transplant diabetes mellitus Risk factors Tacrolimus Graft loss |
| url | http://www.sciencedirect.com/science/article/pii/S1319016422001463 |
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