Original Research
Monday, October 14, 2024
01:00 PM–02:30 PM
Abstract
Introduction: Post-transplant diabetes mellitus (PTDM) is a common complication for kidney transplant recipients (KTRs). PTDM is diagnosed after 45 days post-transplant, and early hyperglycemia (EH) is not recognized as a risk factor for development of PTDM. There is limited data assessing the impact of EH on those without diabetes mellitus (DM) at time of transplant.
Research Question or Hypothesis: KTRs without DM at time of transplant who experience EH will have higher incidences of PTDM.
Study Design: A single-center, retrospective cohort study was conducted in adult KTRs who underwent kidney transplantation from January 1, 2019 to May 25, 2023.
Methods: KTRs who developed EH within 45 days post-transplant were compared against those who did not. The primary outcome was the difference in incidence of PTDM between the EH and control group at 6 months. Secondary outcomes included incidence of PTDM, tacrolimus trough concentrations and coefficient of variation, prednisone use, rejection, graft and patient survival, renal function, rehospitalizations, infections, and cardiovascular events within 12 months.
Results: A total of 279 KTRs (EH group, n=204 vs control group, n=75) were included. Baseline characteristics were similar between groups, except for male gender (58.3% EH vs 38.7% control, p=0.004), Black race (34.6% vs 58.6%, p <0.005), baseline A1c (4.97 ± 0.48 % vs 4.82 ± 0.38%, p=0.018), and alemtuzumab induction (54.4% vs 68%, p=0.041). There were significantly higher incidences of PTDM in the EH group compared to control group at 6 months (11% vs 1.4%, p=0.012) and 12 months post-transplant (18.5% vs 5.5%, p=0.007). KTRs with EH had 2.9 times greater odds of PTDM (OR 2.9; 95% CI 0.845-10) at 6 months. Other confounding variables were not significant for impacting PTDM at 6 months or within 12 months. No statistically significant differences were identified in the secondary outcomes.
Conclusion: KTRs with EH had an increased incidence of developing PTDM.
Presenting Author
Rachel Allen PharmDThe University of Tennessee Health Science Center
Authors
Bonnie Alexander PA
UNC Medical Center
Mary Chandran PharmD, BCTXP, BCPS, CPP, FAST, FCCP
UNC Medical Center
April Goley NP
UNC Medical Center
Joanna Ma PharmD
UNC Medical Center
Taylor Raiger PharmD
UNC Eshelman School of Pharmacy
Emily Stevenson PharmD
University of North Carolina Medical Center
Kristen Szempruch PharmD, BCPS
UNC Health Care