Risk Factors in and Long-Term Survival of Patients with Post-Transplantation Diabetes Mellitus: A Retrospective Cohort Study

Ching-Yao Cheng, Cheng-Hsu Chen, Ming-Fen Wu, Ming-Ju Wu, Jun-Peng Chen, Ying-Mei Liu, Yu-Chi Hou and Hue-Yu Wang
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Ching-Yao Cheng: Department of Pharmacy, Taichung Veterans General Hospital, Taichung 40705, Taiwan
Cheng-Hsu Chen: Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan
Ming-Fen Wu: Department of Pharmacy, Taichung Veterans General Hospital, Taichung 40705, Taiwan
Ming-Ju Wu: Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan
Jun-Peng Chen: Biostatistics Task Force, Taichung Veterans General Hospital, Taichung 40705, Taiwan
Ying-Mei Liu: Department of Pharmacy, Taichung Veterans General Hospital, Taichung 40705, Taiwan
Yu-Chi Hou: School of Pharmacy, China Medical University, Taichung 40402, Taiwan
Hue-Yu Wang: Department of Pharmacy, Chi Mei Medical Center, Tainan City 71004, Taiwan

IJERPH, 2020, vol. 17, issue 12, 1-12

Abstract: Post-transplant diabetes mellitus (PTDM) is associated with infection, cardiovascular morbidity, and mortality. A retrospective cohort study involving patients who underwent renal transplantation in a transplantation center in Taiwan from January 2000 to December 2018 was conducted to investigate the incidence and risk factors of PTDM and long-term patient and graft survival rates. High age (45–65 vs. <45 years, adjusted odds ratio (aOR) = 2.90, 95% confidence interval (CI) = 1.64–5.13, p < 0.001), high body mass index (>27 vs. <24 kg/m 2 , aOR = 5.35, 95% CI = 2.75–10.42, p < 0.001), and deceased organ donor (cadaveric vs. living, aOR = 2.01, 95% CI = 1.03–3.93, p = 0.04) were the three most important risk factors for the development of PTDM. The cumulative survival rate of patients and allografts was higher in patients without PTDM than in those with PTDM (p = 0.007 and 0.041, respectively). Concurrent use of calcineurin inhibitors and mammalian target of rapamycin inhibitors (mTORis) decreased the risk of PTDM (tacrolimus vs. tacrolimus with mTORi, aOR = 0.28, 95% CI = 0.14–0.55, p < 0.001). Investigating PTDM risk factors before and modifying immunosuppressant regimens after transplantation may effectively prevent PTDM development.

Keywords: immunosuppressant; post-transplant diabetes mellitus; risk factor; survival rate (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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