Endocrine Abstracts

Background: The identification of patients with high risk of diabetes mellitus (DM) after renal transplantation in the pre-transplantation period is crucial for the prevention of this pathology and reduction of the risk of cardiovascular morbidity and mortality. With this study we intended to identify the risk factors for NODAT in renal transplantation.

Methods: All patients submitted to renal transplantation at Centro Hospitalar do Porto between 01/01/2009 and 12/31/2013 were retrospectively evaluated. Patients with history of DM, transplantation of more than one organ, younger than 18 years at transplantation, and patients with less than 6 months of follow-up were excluded. DM was defined according to WHO criteria. To identify risk factors for DM, two groups were formed: people with diabetes (DM+) and without diabetes (DM−).

Results: Of the 556 patients undergoing renal transplantation, 247 patients were excluded and 309 patients were eligible for the analysis. A total of 68 patients (22%) with DM criteria were identified, with a mean time to onset of the disease of 8.9±15.3 months posttransplant. Patients were followed for an average of 4.2±1.5 years (DM+) and 4.2±1.8 years (DM−). DM + patients were significantly older at the time of transplantation (54.1±11.5 vs 45.7±13 years, P<0.001), had higher frequency of family history of DM (30.9% (P<0.001), higher obesity rate (17.6% vs 4.6%, P<0.001) and higher deceased-donor rate (86.8% vs 75.5%, P=0.048). There was no statistically significant difference between groups in recipient sex distribution, donor age and sex, renal disease etiology, immunosuppressive therapy used or HCV/CMV infection occurrence.

Discussion and conclusion: The only modifiable pre-transplant risk factor found is obesity, whereby a healthy lifestyle and weight loss should be encouraged within the specific limitations of patients with end-stage renal disease. Since cardiovascular diseases are the main cause of morbidity and mortality in these patients, a tight control of all vascular risk factors is required.