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      KCI등재 SCOPUS SCIE

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

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      https://www.riss.kr/link?id=A108500749

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      다국어 초록 (Multilingual Abstract)

      Background: 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, majoratherosclerotic cardiovascular events (MACEs), and graft failure in KT recipients.
      Methods: We studied a retrospective cohort of KT recipients (between 1994 and 2017) at a single tertiary center, and compared therates 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.
      Results: 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 thenon-diabetes mellitus group (log-rank test, P=0.957 and P=0.079, respectively). Multivariate Cox proportional hazard modelsshowed 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 ofPTDM had a higher incidence of four-point MACE.
      Conclusion: Patient survival and MACEs were comparable between groups with and without PTDM. However, PTDM patientswith long duration diabetes were at higher risk of cardiovascular disease
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      Background: 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...

      Background: 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, majoratherosclerotic cardiovascular events (MACEs), and graft failure in KT recipients.
      Methods: We studied a retrospective cohort of KT recipients (between 1994 and 2017) at a single tertiary center, and compared therates 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.
      Results: 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 thenon-diabetes mellitus group (log-rank test, P=0.957 and P=0.079, respectively). Multivariate Cox proportional hazard modelsshowed 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 ofPTDM had a higher incidence of four-point MACE.
      Conclusion: Patient survival and MACEs were comparable between groups with and without PTDM. However, PTDM patientswith long duration diabetes were at higher risk of cardiovascular disease

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      참고문헌 (Reference)

      1 Jeon JY, "Trends in the effects of pre-transplant diabetes on mortality and cardiovascular events after kidney transplantation" 12 : 811-818, 2021

      2 Gaynor JJ, "Single-centre study of 628 adult, primary kidney transplant recipients showing no unfavourable effect of new-onset diabetes after transplant" 58 : 334-345, 2015

      3 Ahmed SH, "Post-transplantation diabetes mellitus" 11 : 779-801, 2020

      4 Choi JY, "Post-transplant diabetes mellitus : is it associated with poor allograft outcomes in renal transplants?" 45 : 2892-2898, 2013

      5 Cosio FG, "Patient survival after renal transplantation : IV. Impact of post-transplant diabetes" 62 : 1440-1446, 2002

      6 Hariharan S, "Long-term survival after kidney transplantation" 385 : 729-743, 2021

      7 Lentine KL, "Incidence and predictors of myocardial infarction after kidney transplantation" 16 : 496-506, 2005

      8 Schnuelle P, "Impact of renal cadaveric transplantation on survival in end-stage renal failure : evidence for reduced mortality risk compared with hemodialysis during long-term follow-up" 9 : 2135-2141, 1998

      9 Lim WH, "Impact of pretransplant and new-onset diabetes after transplantation on the risk of major adverse cardiovascular events in kidney transplant recipients : a population-based cohort study" 105 : 2470-2481, 2021

      10 Wannamethee SG, "Impact of diabetes on cardiovascular disease risk and all-cause mortality in older men : influence of age at onset, diabetes duration, and established and novel risk factors" 171 : 404-410, 2011

      1 Jeon JY, "Trends in the effects of pre-transplant diabetes on mortality and cardiovascular events after kidney transplantation" 12 : 811-818, 2021

      2 Gaynor JJ, "Single-centre study of 628 adult, primary kidney transplant recipients showing no unfavourable effect of new-onset diabetes after transplant" 58 : 334-345, 2015

      3 Ahmed SH, "Post-transplantation diabetes mellitus" 11 : 779-801, 2020

      4 Choi JY, "Post-transplant diabetes mellitus : is it associated with poor allograft outcomes in renal transplants?" 45 : 2892-2898, 2013

      5 Cosio FG, "Patient survival after renal transplantation : IV. Impact of post-transplant diabetes" 62 : 1440-1446, 2002

      6 Hariharan S, "Long-term survival after kidney transplantation" 385 : 729-743, 2021

      7 Lentine KL, "Incidence and predictors of myocardial infarction after kidney transplantation" 16 : 496-506, 2005

      8 Schnuelle P, "Impact of renal cadaveric transplantation on survival in end-stage renal failure : evidence for reduced mortality risk compared with hemodialysis during long-term follow-up" 9 : 2135-2141, 1998

      9 Lim WH, "Impact of pretransplant and new-onset diabetes after transplantation on the risk of major adverse cardiovascular events in kidney transplant recipients : a population-based cohort study" 105 : 2470-2481, 2021

      10 Wannamethee SG, "Impact of diabetes on cardiovascular disease risk and all-cause mortality in older men : influence of age at onset, diabetes duration, and established and novel risk factors" 171 : 404-410, 2011

      11 Kim JJ, "Impact of diabetes duration on the extent and severity of coronary atheroma burden and long-term clinical outcome in asymptomatic type 2 diabetic patients : evaluation by Coronary CT angiography" 16 : 1065-1073, 2015

      12 Cole EH, "Impact of acute rejection and new-onset diabetes on long-term transplant graft and patient survival" 3 : 814-821, 2008

      13 Kasiske BL, "Diabetes mellitus after kidney transplantation in the United States" 3 : 178-185, 2003

      14 Ying T, "Death after kidney transplantation : an analysis by era and time post-transplant" 31 : 2887-2899, 2020

      15 Wolfe RA, "Comparison of mortality in all patients on dialysis, patients on dialysis awaiting transplantation, and recipients of a first cadaveric transplant" 341 : 1725-1730, 1999

      16 Sehoon Park ; 김명석 ; Ji Eun Kim ; Kwangsoo Kim ; Minsu Park ; Yong Chul Kim ; Kwon Wook Joo ; Yon Su Kim ; Hajeong Lee, "Characteristics of kidney transplantation recipients over time in South Korea" 대한내과학회 35 (35): 1457-1467, 2020

      17 Jardine AG, "Cardiovascular risk and renal transplantation : post hoc analyses of the Assessment of Lescol in Renal Transplantation(ALERT)Study" 46 : 529-536, 2005

      18 Kuo HT, "Associations of pretransplant diabetes mellitus, new-onset diabetes after transplant, and acute rejection with transplant outcomes : an analysis of the Organ Procurement and Transplant Network/United Network for Organ Sharing(OPTN/UNOS)database" 56 : 1127-1139, 2010

      19 Cosentino F, "2019 ESC guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD" 41 : 255-323, 2020

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