PREVALENCE, CLINICAL PROFILE AND OUTCOME OF POST-TRANSPLANT DIABETES MELLITUS: EXPERIENCE OF A TERTIARY CARE CENTRE IN SOUTH INDIA

8 Feb 2025 12 a.m. 12 a.m.
WCN25-AB-2386, Poster Board= SAT-404

Introduction:

Post-transplant diabetes mellitus (PTDM) is a frequent metabolic complication of kidney transplantation and is associated with increased morbidity and mortality. PTDM is a known risk factor for developing Chronic renal allograft injury (CRAI) which has implications for graft and patient survival. 

Aim: To study the prevalence, clinical profile, and renal graft, patient outcome in patients with post-transplant diabetes mellitus (PTDM) in renal transplants.

Methods:

A single-centre retrospective cohort study was conducted at a tertiary care centre in south India from Jan 2016 to June 2023. Adult patients without diabetes mellitus who underwent renal transplants during the study period were included. Patients with diabetes before renal transplant and multiple transplants were excluded.

Results:

Out of the 222 patients who underwent renal transplantation during the study period, 142 were included. There were 106 (74.6%) males in the study. Out of the total patients included, 90% had living donors. The prevalence of PTDM was 19% (27/142) with male preponderance. The mean age of patients in the PTDM group was 43.7±11.6years. Age >40 years (OR – 2.1, P = 0.04), deceased donors (OR – 6.3, P = 0.0024), family history of diabetes (OR – 10.5, P = 0.0016), induction therapy (OR – 1.75, P = 0.04) and prediabetes (OR – 4.9, P = 0.01) before transplant were identified as risk factors for PTDM. Patients with rejection episodes did not have a higher risk of PTDM. Tacrolimus trough level was not an independent risk factor for PTDM (p = 0.27). UTI episodes were more common in the PTDM group with increased frequency post-PTDM diagnosis. CMV infections were common 2/27 (7.4% vs 2.6%) in PTDM patients. In the PTDM group 10/27 (37%) patients had graft dysfunction and 1/27 had graft failure at 1 year follow-up.

 

Clinical parameter

Odds ratio

95% CI

P value

Male sex

1.1941

0.4391 to 3.2474

P = 0.7282

Age (>40 years)

2.1760

0.9169 to 5.1643

P = 0.0479

Deceased donor

6.3000

1.9161 to 20.7140

P = 0.0024

Family H/O diabetes

10.5714

2.4494 to 45.6253

P = 0.0016

Induction therapy

1.7500

0.6520 to 4.6972

P = 0.0466

Slow and delayed graft function

1.1364

0.3825 to 3.3759

P = 0.8180

Prediabetes

4.9545

1.3215 to 18.5758

P = 0.0176

Conclusions:

Our study has shown that 1 in 5 patients who underwent renal transplants develop PTDM in the south Indian population. Age >40 years, deceased donor, family history of diabetes, use of induction therapy, and prediabetic status before transplant were identified as independent risk factors for PTDM.

I have no potential conflict of interest to disclose.

I did not use generative AI and AI-assisted technologies in the writing process.