10.1097\/00007890-200407271-01355<\/a><\/p>\nAuthors:<\/h4>\n
A Yussim, V Bielsky, N Bar-Nathan, E Shaharabani, Idan Burstein, S. Lustig, R Rahamimiov, Eytan Mor<\/p>\n
Abstract:<\/h4>\n
P859 Introduction: New onset post-transplant diabetes mellitus (PTDM) has become increasingly recognized complication of kidney transplantation. Albeit, in the majority of studies during the past decade PTDM rate was found to be significantly higher among patients receiving tacrolimus than cyclosporine, there are major center differences in the reported incidence of PTDM as well as controversy as to the extent of diabetogenicity of tacrolimus (Tac) vs. cyclosporine (Csa). Aim: In this study, we aimed to determine the incidence and dynamics of PTDM in a cohort of consecutive renal transplant recipients remaining on Csa or switched to Tac and followed up for 5 years. Methods: We studied records of all consecutive renal graft recipients (n 107), excluding those with pretransplant diabetes mellitus, transplanted in 1998 and followed up throughout 1998-2003 for new onset of PTDM, defined as de-novo hyperglycemia (glucose >120 mg\/dL) treated for more than 1 month. The posttransplant immunosuppression consisted of Csa (Neoral) \u2013 started at 10 mg\/kg and adjusted to blood levels of 300ng\/ml (0-3 mos), 200-250 ng\/ml (3-6 mos), 150-200 ng\/ml (6-12 mos), 100-150 ng\/ml (> 12 mos) or Tac- started at 0.15 mg\/kg and adjusted to blood levels of 15-20 ng\/ml (0-1 mos), 10-15 ng\/ml (1-6 mos), 5-10 ng\/ml (>6 mos) given in conjunction with prednisone – 500 mg\/d of solumedrol, followed by prednisone 100 mg\/d >30 mg\/d > 20 mg\/d > 10 mg\/d tapering over 6 months, azathioprine \u2013 at 150 mg\/d, or replaced by mycophenolate mofetil – 1.0-2.0 gr\/d. The patients were divided into 2 groups: those remaining on Csa (n 43) and those started (n 19) or switched to Tac (n 45). Patient demographics, PRA, HLA match, donor organ parameters, incidence of PTDM, graft and patient survival, and renal function in patients on Csa (Neoral) and Tac were compared, when appropriate, by Wilcoxon Two-Sample, Chi-Square, Fisher\u2019s Exact, T test, Gehan-Wilcoxon, Cox-Mantel, Log rank and Kaplan-Meier tests (SAS statistical software). Results: PTDM was detected in 12\/107 patients (11.2%). At the time of its appearance, PTDM prevalence in patients under Tac and Csa -5\/50 (10%) and 7\/57 (12.2%), respectively was not significantly different (Fisher, Chi test NS). Highest prevalence of new PTDM cases was observed in the first post-transplant year \u2013 11\/12 cases (91.7%). In contrast to some previous reports, mellow slope of the PTDM increase was observed on predominantly low-dose FK based protocol after the first year, with the calculated annual elevation of 0.25% in the posttransplant years 2-5. Conclusions: Our results show the PTDM cumulative 5 year incidence of 11.2%. No significant difference in PTDM incidence was found between Csa and Tac treatment (12.2% and 10% over 5 years, respectively). Therefore, it appears that in comparison with Csa immunosuppression, our current, tacrolimus-based protocol is not associated with the increased incidence of PTDM.<\/p>\n","protected":false},"excerpt":{"rendered":"
DOI: 10.1097\/00007890-200407271-01355 Authors: A Yussim, V Bielsky, N Bar-Nathan, E Shaharabani, Idan Burstein, S. Lustig, R Rahamimiov, Eytan Mor Abstract: P859 Introduction: New onset post-transplant diabetes mellitus (PTDM) has become increasingly recognized complication of kidney transplantation. Albeit, in the majority of studies during the past decade PTDM rate was found to be significantly higher among […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[18],"tags":[],"class_list":["post-869","post","type-post","status-publish","format-standard","hentry","category-mos200"],"_links":{"self":[{"href":"https:\/\/citations.tools.bio-logic.fr\/index.php?rest_route=\/wp\/v2\/posts\/869","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/citations.tools.bio-logic.fr\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/citations.tools.bio-logic.fr\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/citations.tools.bio-logic.fr\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/citations.tools.bio-logic.fr\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=869"}],"version-history":[{"count":0,"href":"https:\/\/citations.tools.bio-logic.fr\/index.php?rest_route=\/wp\/v2\/posts\/869\/revisions"}],"wp:attachment":[{"href":"https:\/\/citations.tools.bio-logic.fr\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=869"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/citations.tools.bio-logic.fr\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=869"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/citations.tools.bio-logic.fr\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=869"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}