A Retrospective Study About The Risk Factors For New-Onset Diabetes Mellitus After Kidney Transplantation

ObjectiveWe investigate the risk factors about New-Onset Diabetes Mellitus after kidney transplantation,to provide references for identifying the high-risk kidney transplant recipients and taking preventive measures.Method1.Meta-analysis We electronically searched the databases of Pubmed,Embase,CBM and WanFang from January 1990 to March 2017 to identify relevant case-control and cohort studies reporting risk factors for new-onset diabetes mellitus after kidney transplantation.2.Retrospective study365 patients who underwent consecutive first kidney transplantation in kidney transplantation at the general Hospital of shanghai JiaoTong university from December 2004 to December 2014 were included.These patients were not diabetes before operation and their survival are more than 1 year.According to the diagnostic criteria of NOD AT,they are divided into two groups,71 non-diabetic transplant recipients diagnosed as having NOD AT during the one year follow-up period after transplantation is the NOD AT group,294 transplant recipients not diagnosed NOD AT is the N-NODAT group.Analyze all variables that may be related to the development of NOD AT,including age,Body Mass Index(BMI),a family history of diabetes mellitus,use of tacrolimus and AR and so on.Results1.MetaTwenty-two studies with 81 51kidney transplant recipients were included in the meta-analysis,the incidence of NOD AT is 17.75%.The meta-analysis identified the following non-modifiable risk factors:Age?45years;Deceased donor.Modifiable risk factors:BMI>25Kg/m;AR;use of tacrolimus;HCV infection(Hepatitis C Virus);polycystic kidney.Other factors,such as gender?Hypertension?Smoking history and CMV(CytoMegaloVirus)infection were not found to be associated with the incidence of NOD AT.Because of the inconsistent results of cohort studies and case-control studies,it is not clear that a family history of Diabetes Mellitus is risk factors for NOD AT.2.Retrospective studyA total of 365 patients were enrolled.The Cumulative incidence of new-onset diabetes mellitus after kidney transplantation within 1 year is 19.45%.Univariate analysis showed that age,BMI,A family history of diabetes mellitus,HCV infection and so on were associated with NOD AT.By Unconditional logistic regression analysis,Age?45years,BMI?25Kg/m2,AR,A family history of Diabetes mellitus were independent risk factors for NOD AT.ConclusionOld age,A family history of diabetes Mellitus,pre-transplant high BMI,and AR are independent factors associated with the development of diabetes after renal transplantation.We should pay attention to the risk factors of NOD AT,improve the vigilance of high-risk renal transplant recipients,take related measures early,to reduce the incidence of NODAT.