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Effect of post-transplant diabetes mellitus on cardiovascular events and mortality: a single‐center retrospective cohort study

  • Uğur Ünlütürk,
  • Tolga Yıldırım,
  • Merve Savaş,
  • Seda Hanife Oğuz,
  • Büşra Fırlatan,
  • Deniz Yüce,
  • Nesrin Damla Karakaplan,
  • Cemile Selimova,
  • Rahmi Yılmaz,
  • Yunus Erdem,
  • Miyase Bayraktar

摘要

Purpose

This study aims to investigate the impact of post-transplant diabetes mellitus (PTDM) on cardiovascular events, graft survival, and mortality and to determine the risk factors involved in developing PTDM.

Methods

A total of 703 patients who underwent kidney transplantation were included in the study. The total sample was subdivided into three groups: (i) patients with PTDM; (ii) patients who had diabetes before the transplantation (DM); and (iii) patients without diabetes (NoDM). The data on graft failure, cardiovascular events, all-cause mortality, and the potential risk factors that play a role in developing PTDM were recorded and analyzed.

Results

The patients were followed for a median of 80 (6–300) months after transplantation. Out of all patients, 41 (5.8%) had DM before transplantation, and 101 (14.4%) developed PTDM. Recipient BMI, post-transplant fasting plasma glucose, and hepatitis C seropositivity were independent risk factors for PTDM development. The incidence of cardiovascular events was 6.1% in the NoDM group, 14.9% in the PTDM group, and 29.3% in the DM group (p < 0.001). In PTDM patients, hepatitis C seropositivity and the recipient’s age at transplant were independent predictors of a cardiovascular event. There were no significant differences between the groups regarding the risk of graft loss. PTDM had no significant effect on all-cause mortality. However, the survival rates of DM patients were significantly reduced compared to those with NoDM or PTDM.

Conclusions

PTDM had no impact on patient survival. Hepatitis C seropositivity and recipient age at transplant predicted cardiovascular events in PTDM patients.