Clinical outcomes of posttransplantation diabetes mellitus in kidney transplantation recipients: a nationwide population-based cohort study in Korea
Abstract Posttransplantation diabetes mellitus (PTDM) is an important metabolic complication after KT that causes graft failure and cardiovascular complications in kidney transplantation (KT) recipients. Using the national claim data of South Korea, 7612 KT recipients between 2009 and 2017 were anal...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2022-12-01
|
| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-022-25070-z |
| _version_ | 1811198412287115264 |
|---|---|
| author | Eunjeong Kang Jangwook Lee Dong Hyun Kang Jina Park Sehoon Park Yong Chul Kim Dong Ki Kim Kwon Wook Joo Yon Su Kim Minsu Park Yaeji Lim Hajeong Lee |
| author_facet | Eunjeong Kang Jangwook Lee Dong Hyun Kang Jina Park Sehoon Park Yong Chul Kim Dong Ki Kim Kwon Wook Joo Yon Su Kim Minsu Park Yaeji Lim Hajeong Lee |
| author_sort | Eunjeong Kang |
| collection | DOAJ |
| description | Abstract Posttransplantation diabetes mellitus (PTDM) is an important metabolic complication after KT that causes graft failure and cardiovascular complications in kidney transplantation (KT) recipients. Using the national claim data of South Korea, 7612 KT recipients between 2009 and 2017 were analyzed. PTDM was defined as a consecutive 30-day prescription history of antidiabetic medication after KT. Among these patients, 24.7% were diagnosed with PTDM, and 51.9% were diagnosed within 6 months after KT. Compared to patients without PTDM, those with PTDM were older, more likely to be men, more likely to be diagnosed with hypertension and cardio-cerebrovascular disease, and experienced more rejection episodes requiring high-dose steroid treatment after KT. During the follow-up, 607 DCGFs, 230 DWGFs, 244 MACEs, and 260 all-cause mortality events occurred. Patients with PTDM showed a higher risk of DCGF (adjusted hazard ratio [aHR] 1.49; 95% confidence interval [CI] 1.22–1.82; P < 0.001) and MACEs (aHR 1.76; 95% CI 1.33–2.31; P < 0.001) than patients without PTDM. The risks for all clinical outcomes were higher in the insulin group than in the non-use insulin group. PTDM in KT recipients resulted in both worse allograft and patient outcomes represented by DCGF and MACE, especially in patients needing insulin treatment. |
| first_indexed | 2024-04-12T01:31:09Z |
| format | Article |
| id | doaj.art-bec6dffdce784e49b65d886985fad015 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-04-12T01:31:09Z |
| publishDate | 2022-12-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-bec6dffdce784e49b65d886985fad0152022-12-22T03:53:30ZengNature PortfolioScientific Reports2045-23222022-12-011211810.1038/s41598-022-25070-zClinical outcomes of posttransplantation diabetes mellitus in kidney transplantation recipients: a nationwide population-based cohort study in KoreaEunjeong Kang0Jangwook Lee1Dong Hyun Kang2Jina Park3Sehoon Park4Yong Chul Kim5Dong Ki Kim6Kwon Wook Joo7Yon Su Kim8Minsu Park9Yaeji Lim10Hajeong Lee11Department of Internal Medicine, Ewha Womans University Seoul Hospital, Ewha Womans University College of MedicineDepartment of Internal Medicine, Dongguk University Ilsan HospitalDepartment of Applied Statistics, Chung-Ang UniversityBiomedical Research Institute, Seoul National University HospitalDepartment of Biomedical Sciences, Seoul National University College of MedicineDepartment of Internal Medicine, Seoul National University HospitalDepartment of Internal Medicine, Seoul National University HospitalDepartment of Internal Medicine, Seoul National University HospitalDepartment of Internal Medicine, Seoul National University HospitalDepartment of Informations and Statistics, Chungnam National UniversityDepartment of Applied Statistics, Chung-Ang UniversityDepartment of Internal Medicine, Seoul National University HospitalAbstract Posttransplantation diabetes mellitus (PTDM) is an important metabolic complication after KT that causes graft failure and cardiovascular complications in kidney transplantation (KT) recipients. Using the national claim data of South Korea, 7612 KT recipients between 2009 and 2017 were analyzed. PTDM was defined as a consecutive 30-day prescription history of antidiabetic medication after KT. Among these patients, 24.7% were diagnosed with PTDM, and 51.9% were diagnosed within 6 months after KT. Compared to patients without PTDM, those with PTDM were older, more likely to be men, more likely to be diagnosed with hypertension and cardio-cerebrovascular disease, and experienced more rejection episodes requiring high-dose steroid treatment after KT. During the follow-up, 607 DCGFs, 230 DWGFs, 244 MACEs, and 260 all-cause mortality events occurred. Patients with PTDM showed a higher risk of DCGF (adjusted hazard ratio [aHR] 1.49; 95% confidence interval [CI] 1.22–1.82; P < 0.001) and MACEs (aHR 1.76; 95% CI 1.33–2.31; P < 0.001) than patients without PTDM. The risks for all clinical outcomes were higher in the insulin group than in the non-use insulin group. PTDM in KT recipients resulted in both worse allograft and patient outcomes represented by DCGF and MACE, especially in patients needing insulin treatment.https://doi.org/10.1038/s41598-022-25070-z |
| spellingShingle | Eunjeong Kang Jangwook Lee Dong Hyun Kang Jina Park Sehoon Park Yong Chul Kim Dong Ki Kim Kwon Wook Joo Yon Su Kim Minsu Park Yaeji Lim Hajeong Lee Clinical outcomes of posttransplantation diabetes mellitus in kidney transplantation recipients: a nationwide population-based cohort study in Korea Scientific Reports |
| title | Clinical outcomes of posttransplantation diabetes mellitus in kidney transplantation recipients: a nationwide population-based cohort study in Korea |
| title_full | Clinical outcomes of posttransplantation diabetes mellitus in kidney transplantation recipients: a nationwide population-based cohort study in Korea |
| title_fullStr | Clinical outcomes of posttransplantation diabetes mellitus in kidney transplantation recipients: a nationwide population-based cohort study in Korea |
| title_full_unstemmed | Clinical outcomes of posttransplantation diabetes mellitus in kidney transplantation recipients: a nationwide population-based cohort study in Korea |
| title_short | Clinical outcomes of posttransplantation diabetes mellitus in kidney transplantation recipients: a nationwide population-based cohort study in Korea |
| title_sort | clinical outcomes of posttransplantation diabetes mellitus in kidney transplantation recipients a nationwide population based cohort study in korea |
| url | https://doi.org/10.1038/s41598-022-25070-z |
| work_keys_str_mv | AT eunjeongkang clinicaloutcomesofposttransplantationdiabetesmellitusinkidneytransplantationrecipientsanationwidepopulationbasedcohortstudyinkorea AT jangwooklee clinicaloutcomesofposttransplantationdiabetesmellitusinkidneytransplantationrecipientsanationwidepopulationbasedcohortstudyinkorea AT donghyunkang clinicaloutcomesofposttransplantationdiabetesmellitusinkidneytransplantationrecipientsanationwidepopulationbasedcohortstudyinkorea AT jinapark clinicaloutcomesofposttransplantationdiabetesmellitusinkidneytransplantationrecipientsanationwidepopulationbasedcohortstudyinkorea AT sehoonpark clinicaloutcomesofposttransplantationdiabetesmellitusinkidneytransplantationrecipientsanationwidepopulationbasedcohortstudyinkorea AT yongchulkim clinicaloutcomesofposttransplantationdiabetesmellitusinkidneytransplantationrecipientsanationwidepopulationbasedcohortstudyinkorea AT dongkikim clinicaloutcomesofposttransplantationdiabetesmellitusinkidneytransplantationrecipientsanationwidepopulationbasedcohortstudyinkorea AT kwonwookjoo clinicaloutcomesofposttransplantationdiabetesmellitusinkidneytransplantationrecipientsanationwidepopulationbasedcohortstudyinkorea AT yonsukim clinicaloutcomesofposttransplantationdiabetesmellitusinkidneytransplantationrecipientsanationwidepopulationbasedcohortstudyinkorea AT minsupark clinicaloutcomesofposttransplantationdiabetesmellitusinkidneytransplantationrecipientsanationwidepopulationbasedcohortstudyinkorea AT yaejilim clinicaloutcomesofposttransplantationdiabetesmellitusinkidneytransplantationrecipientsanationwidepopulationbasedcohortstudyinkorea AT hajeonglee clinicaloutcomesofposttransplantationdiabetesmellitusinkidneytransplantationrecipientsanationwidepopulationbasedcohortstudyinkorea |