No apparent impact of increased post-operative blood glucose levels on clinical outcome in kidney transplant recipients

• Published in: Clinical transplantation Vol. 23; no. 2; pp. 256 - 263
• Main Authors: Van Den Berg, Tijs J., Bogers, Hein, Vriesendorp, Titia M., Surachno, Janto S., DeVries, J. Hans, Ten Berge, Ineke J., Hoekstra, Joost B.L.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.03.2009; Wiley
• Subjects: Biological and medical sciences; Blood Glucose - metabolism; Cohort Studies; Diabetes Mellitus - mortality; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Graft Rejection - prevention & control; Graft Survival; Humans; hyperglycemia; Hyperglycemia - mortality; infection; Kidney Transplantation; Male; Medical sciences; Middle Aged; post-transplant diabetes; Postoperative Period; rejection; renal transplantation; Retrospective Studies; risk factor; Risk Factors; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the urinary system; Surgical Wound Infection - mortality; Survival Rate; Tissue, organ and graft immunology; Endocrinopathy; Graft(material); Prognosis; renal transplantation; Homotransplantation; Epidemiology; Kidney; Blood; Hyperglycemia; Surgery; posttransplant diabetes; Evolution; Graft; Postoperative; Diabetes mellitus; Exploration; Concentration; Infection; Medicine; Rejection; Treatment; Urinary system; Risk factor; Glycemia; Kidney transplantation
• ISSN: 0902-0063; 1399-0012
• DOI: 10.1111/j.1399-0012.2008.00910.x

:  Background:  Our objective is to evaluate whether hyperglycemia in the first 48 h after renal transplantation is independently associated with rejection, post‐operative infection and post‐transplant diabetes mellitus (PTDM) in a retrospective cohort study. Methods:  Patients who received a renal transplant in our hospital in 2003 or 2004 were included. Glucose values until 48 h after surgery were retrieved from laboratory reports. Biopsy proven acute rejection, culture proven infections and PTDM were scored until four months after transplantation. Data were analyzed using univariate analysis and logistic multivariate analysis. Results:  At least one post‐operative glucose value could be retrieved for 150/151 patients. Rejection occurred in 46/150 (30.5%), infection in 47/150 (31.1%) and PTDM in 19/150 (12.6%) patients. When corrected for other risk factors, no relation was found between post‐operative glucose levels and rejection (weak inverse relation, OR = 0.82; 95% CI = 0.65–1.03; p = 0.09), post‐operative glucose and infections (OR = 0.98; 95% CI = 0.80–1.21; p = 0.84) and post‐operative glucose and PTDM (OR = 0.93; 95% CI = 0.70–1.23; p = 0.63). Conclusion:  Increased post‐operative blood glucose levels after renal transplantation were not found to be a risk factor for graft rejection. Also, post‐operative glucose levels were not found to be associated with PTDM and post‐operative infections.