Glucocorticoid pathway polymorphisms and diabetes after kidney transplantation

• Published in: Clinical nephrology Vol. 96; no. Suppl 1; pp. 114 - 118
• Main Authors: Pahor, Klemen, Maver, Blaž, Blagus, Tanja, Vončina, Blaž, Praznik, Monika, Goričar, Katja, Dolžan, Vita, Arnol, Miha, Mlinšek, Gregor
• Format: Journal Article
• Language: English
• Published: 2021
• ISSN: 0301-0430
• DOI: 10.5414/CNP96S20

AIMSTo find possible associations between new-onset diabetes after transplantation and polymorphisms in glucocorticoid pathway. MATERIALS AND METHODSA total of 290 patients from our national cohort of kidney transplant patients with functioning graft transplanted in 6 consecutive years (2010 - 2015) were included in the study. All patients were genotyped for polymorphisms in genes coding for glucocorticoid receptor (NR3C1 rs33389, rs6198 and rs33388), P-glycoprotein (ABCB1 rs1045642, rs1128503, and rs2032582), and glutathione S-transferase P1 (GSTP1 rs1695 and rs1138272). For interim analysis, clinical data were obtained from medical records for 79 patients. RESULTS22.8% of patients developed NODAT in the first post-transplant year. GSTP1 rs1695 and rs1138272 polymorphisms were associated with an increased risk for NODAT. NR3C1 rs6198 polymorphism was associated with higher serum glucose at the end of the first post-transplant year. CONCLUSIONThe observed incidence of NODAT in the first post-transplant year is in accordance with the literature data. GSTP1 genotypes leading to decreased conjugation capacity were associated with higher probability of NODAT. As these polymorphisms can be determined already before kidney transplantation, they can help planning early glucocorticoid withdrawal if a favorable post-transplant course permits it.