| Objective Currently,Kidney transplantation has become an important treatment for end-stage renal disease,however post-transplant diabetes mellitus(PTDM)is a common postoperative complication that increases the cardiovascular risk and mortality risk of patients.Therefore,in this study,we retrospectively analyzed the related clinical data of renal allograft recipients,aiming to investigate the risk factors affecting the occurrence of PTDM and provide more reference data and evidence for its prediction and diagnosis.Methods Case data of patients who underwent renal allograft transplantation in Shulan(Hangzhou)hospital from October 2017 to October 2020 were collected,and the basic clinical characteristics and glycemic changes of patients after renal transplantation were analyzed descriptively according to the inclusion and exclusion criteria adopted in this study.Renal transplant recipients were divided into PTDM and normoglycemic groups according to the diagnostic criteria of PTDM adopted in this study.Case data were collected as follows:general clinical data including gender,age,body mass index(BMI),blood group,smoking history,alcohol consumption history,hypertension history and polycystic kidney disease history;Relevant preoperative data included fasting plasma glucose(FPG),fasting total cholesterol,fasting triglycerides(TG),fasting high-density lipoprotein cholesterol(HDL-C),fasting low-density lipoprotein cholesterol,serum magnesium,serum calcium,hepatitis A virus infection,hepatitis B virus infection,hepatitis C virus infection,hepatitis D virus infection,Hepatitis E virus(HEV)infection,population reactive antibodies and human leukocyte antigen(HLA);Relevant postoperative data included postoperative inflammatory status[white blood cell count,percentage of neutrophils and C-reactive protein(CRP)on postoperative day 1],dialysis history,recovery of graft function,history of acute rejection,Epstein Barr virus infection,cytomegalovirus(CMV)infection,JC virus infection,BK virus infection,Immunosuppressive regimen and history of abnormally elevated blood concentrations of calcineurin inhibitors(CNIs).Data were analyzed using SPSS 25.0 statistical software,continuous type variables were compared using t-test or rank sum test,dichotomous variables were compared using chi square test or Fisher’s exact probability method,and binary logistic regression analysis was used to explore the possible risk factors affecting the occurrence of PTDM.Results 1.Among 431 allograft recipients in our hospital,a total of 336 recipients developed abnormal glucose metabolism within 1 year after operation,including 91 PTDM recipients,accounting for 21.11%.2.Univariate analysis found that patients in the PTDM group had significantly higher age(P<0.001),preoperative BMI(P<0.001),preoperative FPG(P<0.001),preoperative fasting TG(P<0.001),and postoperative CRP(P=0.002)than those in the normoglycemic group,whereas preoperative fasting HDL-C(P=0.021)and preoperative serum magnesium(P=0.048)were significantly lower than those in the normoglycemic group.There were more patients with HEV infection(P=0.034)and HLA-B46 positivity(P=0.037)in the PTDM group before renal transplantation.Whereas after renal transplantation,more patients used tacrolimus(P=0.029)and had a history of abnormally elevated blood concentration of CNI(P=0.042)in the PTDM group.3.Binary logistic regression analysis identified that the patients’ age[odds ratio(OR)=1.049,95%confidence interval(CI):1.006-1.093,P=0.026],preoperative BMI(OR=1.279,95%CI:1.072-1.526,P=0.039),CRP on postoperative day 1(OR=1.026,95%CI:1.003-1.050,P=0.024)and postoperative tacrolimus use(OR=4.084,95%CI:1.631-10.225,P=0.003)may be risk factors for the development of PTDM after renal transplantation.Conclusion Age,preoperative BMI,preoperative FPG,HLA-B46 positivity,CRP on postoperative day 1,and postoperative tacrolimus use may be independent risk factors for the development of PTDM after renal transplantation. |
