Impact of Post-Transplant Diabetes Mellitus on Survival and Cardiovascular Events in Kidney Transplant Recipients

• Published in: Endocrinology and metabolism (Seoul) Vol. 38; no. 1; pp. 139 - 145
• Main Authors: Jeon, Ja Young, Han-Bit, Shin, Park, Bum Hee, Lee, Nami, Kim, Hae Jin, Kim, Dae Jung, Lee, Kwan-Woo, Han, Seung Jin
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Endocrine Society 01.02.2023
• Subjects: cardiovascular diseases; Cardiovascular Diseases - complications; Cardiovascular Diseases - etiology; diabetes mellitus; Diabetes Mellitus - etiology; graft survival; Humans; kidney transplantation; Kidney Transplantation - adverse effects; mortality; Original; Retrospective Studies; Risk Factors; Graft survival; Cardiovascular diseases; Diabetes mellitus; Mortality; Kidney transplantation
• ISSN: 2093-596X; 2093-5978
• DOI: 10.3803/EnM.2022.1594

Post-transplant diabetes mellitus (PTDM) is a risk factor for poor outcomes after kidney transplantation (KT). However, the outcomes of KT have improved recently. Therefore, we investigated whether PTDM is still a risk factor for mortality, major atherosclerotic cardiovascular events (MACEs), and graft failure in KT recipients. We studied a retrospective cohort of KT recipients (between 1994 and 2017) at a single tertiary center, and compared the rates of death, MACEs, overall graft failure, and death-censored graft failure after KT between patients with and without PTDM using Kaplan-Meier analysis and a Cox proportional hazard model. Of 571 KT recipients, 153 (26.8%) were diagnosed with PTDM. The mean follow-up duration was 9.6 years. In the Kaplan- Meier analysis, the PTDM group did not have a significantly increased risk of death or four-point MACE compared with the non-diabetes mellitus group (log-rank test, P=0.957 and P=0.079, respectively). Multivariate Cox proportional hazard models showed that PTDM did not have a negative impact on death or four-point MACE (P=0.137 and P=0.181, respectively). In addition, PTDM was not significantly associated with overall or death-censored graft failure. However, patients with a long duration of PTDM had a higher incidence of four-point MACE. Patient survival and MACEs were comparable between groups with and without PTDM. However, PTDM patients with long duration diabetes were at higher risk of cardiovascular disease.