Predictors of new-onset diabetes mellitus after kidney transplant
New-onset diabetes mellitus is relatively common after kidney transplantation, a new meta-analysis has found. Risk factors include older age, body mass index (BMI), family history, and some comorbidities.
Accessing the databases of PubMed, Web of Science, Embase, and the Cochrane library, researchers were able to retrieve 24 case-control studies eligible for inclusion into the meta-analysis. This corresponded to 6,127 kidney transplant patients, of whom 1,598 developed new-onset diabetes mellitus after the procedure.
Pooled analysis of 17 studies showed that, after the heterogeneity test (p<0.00001), age was a significant risk factor for the development of new-onset diabetes mellitus after kidney transplant (mean difference [MD], 6.05, 95 percent confidence interval [CI], 4.33–7.78; p<0.00001). Sex, on the other hand, was not a significant correlate of the outcome (odds ratio [OR], 1.00, 95 percent CI, 0.88–1.13; p=0.97).
Other significant risk factors included polycystic kidney disease (OR, 1.69, 95 percent CI, 1.22–2.34; p=0.002), a family history of diabetes mellitus (OR, 3.14, 95 percent CI, 1.87–5.27; p<0.0001), high BMI (MD, 1.82, 95 percent CI, 1.35–2.30; p<0.00001), and acute rejection (OR, 1.97, 95 percent CI, 1.61–2.41; p<0.00001).
Similarly, the use of tacrolimus (OR, 1.20, 95 percent CI, 1.02–1.41; p=0.03) emerged as a significant risk factor, while other medications, such as sirolimus, cyclosporin A, and steroids, were not. Infections with hepatitis B (OR, 3.53, 95 percent CI, 1.12–11.13; p=0.03) and C (OR, 1.51, 95 percent CI, 1.01–2.24; p=0.04) were also significant correlated of new-onset diabetes mellitus.