TY  - JOUR
T1  - Risk factors for post-transplant diabetes mellitus in kidney transplant recipients: a single-center retrospective study
TT  - Transplantasyon sonrası diyabet mellitusun greft sağkalımı ve mortalite üzerindeki etkisi: tek merkezli retrospektif kohort çalışması
AU  - Çakmak, Ümit
AU  - Merhametsiz, Özgür
AU  - Akkaya, Süleyman
AU  - Ay, Nurettin
PY  - 2025
DA  - October
Y2  - 2025
DO  - 10.38053/acmj.1796033
JF  - Anatolian Current Medical Journal
JO  - Anatolian Curr Med J / ACMJ / acmj
PB  - MediHealth Academy Yayıncılık
WT  - DergiPark
SN  - 2718-0115
SP  - 933
EP  - 939
VL  - 7
IS  - 6
LA  - en
AB  - Aims: Kidney transplantation is one of the preferred treatment modalities in end-stage renal disease (ESRD) and significantly preserves kidney function and the patient's quality of life. However, post-transplant diabetes mellitus (PTDM) is a common complication, occurring in approximately one-third of renal transplant recipients. The main aims of our study were to determine the risk factors associated with the development of PTDM in renal transplant patients, to demonstrate its incidence, and to evaluate its long-term consequences on graft and patient survival.Methods: This single-center retrospective study included 242 non-diabetic kidney transplant recipients who underwent transplantation between January 2014 and December 2022. Patients with pre-existing diabetes, younger than 18 years old, multiple transplants or graft survival of less than one year were excluded. Demographic data, immunosuppressive regimens, perioperative glucose levels and laboratory findings were collected. All patients classified as having PTDM required glucose lowering treatment—either oral antidiabetic agents or insulin—initiated after the third month post-transplant, confirming the persistence of hyperglycemia beyond the early postoperative period. Statistical analysis were performed using IBM SPSS 22 with categorical variables compared using Pearson Chi-square test and continuous variables using Mann-Whitney U test. ROC analysis logistic regression were conducted to identify risk factors for PTDM. Results: PTDM developed more frequently in older (45 vs. 33 years, p
KW  - Kidney transplantation
KW  - post-transplant diabetes mellitus
KW  - risk factors
KW  - body mass index
KW  - coronary artery disease
N2  - Amaç: Böbrek transplantasyonu, son dönem böbrek hastalığında (SDBH) tercih edilen tedavi yöntemlerinden biri olup, böbrek fonksiyonlarını ve hastanın yaşam kalitesini önemli ölçüde korur. Ancak, post-transplant diyabetes mellitus (PTDM) sık görülen bir komplikasyondur ve böbrek nakli alıcılarının yaklaşık üçte birinde ortaya çıkar. Bu çalışmanın temel amacı, böbrek nakli alıcılarında PTDM gelişimi ile ilişkili risk faktörlerini belirlemek, insidansını göstermek ve uzun dönem greft ile hasta sağkalımı üzerindeki etkilerini değerlendirmektir.Yöntemler: Tek merkezli retrospektif bu çalışmaya Ocak 2014 – Aralık 2022 tarihleri arasında böbrek transplantasyonu yapılan 242 diyabetik olmayan hasta dahil edilmiştir. Önceden diyabeti olan, 18 yaşından küçük, çoklu transplant geçiren veya greft sağkalımı bir yıldan az olan hastalar çalışmaya dahil edilmemiştir. Demografik veriler, immünsüpresif tedavi rejimleri, perioperatif glukoz düzeyleri ve laboratuvar bulguları kayıt edilmiştir. İstatistiksel analizler IBM SPSS 22 programı kullanılarak yapılmış; kategorik değişkenler Pearson Ki-kare testi, sürekli değişkenler Mann-Whitney U testi ile karşılaştırılmıştır. PTDM risk faktörlerini belirlemek için ROC analizi ve lojistik regresyon analizi uygulanmıştır.Bulgular: Çalışmamızda PTDM insidansı %15,2 olarak bulunmuştur. PTDM gelişen hastalar daha yaşlı (45 vs. 33 yıl, p
CR  - Turkey 2022 National Nephrology, Dialysis, and Transplantation Registry Report." 2022. https://nefroloji.org.tr/uploads/pdf/REGISTRY2022_ web.pdf
CR  - Kasiske BL, Snyder JJ, Gilbertson D, et al. Diabetes mellitus after kidney transplantation in the United States. Am J Transpl. 2003;3(2):178-185. doi:10.1034/j.1600-6143.2003.00010.x
CR  - Gomes MB, Cobas RA. Post-transplant diabetes mellitus. Diabetol Metab Syndr. 2009;5(1):1-14. doi:10.1186/1758-5996-1-14
CR  - Hecking M, Werzowa, J, Haidinger M, et al. Novel views on new-onset diabetes after transplantation: development, prevention and treatment. Nephrol. Dial. Transplant. 2013;28(3):550-566. doi:10.1093/ndt/gfs583
CR  - Lv C, Chen M, Xu M, et al. Influencing factors of new-onset diabetes after renal transplant and their effects on complications and survival rate. PLoS One. 2014;9(6):e99406. doi:10.1371/journal.pone.0099406
CR  - Einollahi B, Motalebi M, Salesi M, et al. The impact of cytomegalovirus infection on new-onset diabetes mellitus after kidney transplantation: a review on current findings. J Nephropathol. 2014;3(4):139-148. doi:10. 12860/jnp.2014.27
CR  - Ling Q, Xu X, Xie H, et al. New-onset diabetes after liver transplantation: a national report from China Liver Transplant Registry. Liver Int.  2016; 36:705-712. doi:10.1111/liv.13042
CR  - Cehic MG, Nundall N, Greenfield JR, Macdonald PS. Management strategies for posttransplant diabetes mellitus after heart transplantation: a review. J Transplant. 2018;2018:1025893. doi:10.1155/2018/1025893
CR  - American Diabetes Association Standards of medical care in diabetes— 2020. Diabetes Care 2020;43:S14-S31.  doi:10.2337/dc20-S002
CR  - Sharif A, Hecking M, de Vries APJ, et al. International consensus on post-transplantation diabetes mellitus. Nephrol Dial Transplant. 2024: 28;39:531-549. doi:10.1093/ndt/gfad258
CR  - Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group. KDIGO clinical practice guideline for acute kidney injury. Kidney Int. 2012;2:1-138.
CR  - Brzezinska B, Junik R, Kaminska A, et al. Factors associated with glucose metabolism disorder after kidney transplantation. Endokrynol Pol. 2013;64:21-25.
CR  - Cosio FG, Pesavento TE, Osei K, et al. Posttransplant diabetes mellitus: increasing incidence in renal allograft recipients transplanted in recent years. Kidney Int. 2001;59(2):732-737. doi:10.1046/j.1523-1755.2001. 059002732.x
CR  - Kirnap NG, Bozkus Y, Haberal M. Analysis of risk factors for posttransplant diabetes mellitus after kidney transplantation: single-center experience. Exp Clin Transplant. 2020;18(Suppl 1):36-40. doi:10. 6002/ect.TOND-TDTD2019.O8
CR  - Kahn SE. The relative contributions of insulin resistance and beta-cell dysfunction to the pathophysiology of type 2 diabetes. Diabetologia. 2003;46(1):3-19. doi:10.1007/s00125-002-1009-0
CR  - 2019 Guidelines on the management of diabetic patients. A position of Diabetes Poland. Clin Diabetol. 2019;8(1):1-95. doi:10.5603/DK.2019.0001
CR  - Axelrod DA, Cheungpasitporn W, Bunnapradist S, et al. Posttransplant diabetes mellitus and immunosuppression selection in older and obese kidney recipients. Kidney Med. 2021;22:4:100377. doi:10.1016/j.xkme. 2021.08.012
CR  - Malik RF, Jia Y, Mansour SG, Reese PP, et al. Posttransplant diabetes mellitus in kidney transplant recipients: a multicenter study. Kidney360. 2021;2:1296-1307. doi:10.34067/KID.0000862021
CR  - Hjelmesaeth J, Flyvbjerg A, Jenssen T, et al. Hypoadiponectinemia is associated with insulin resistance and glucose intolerance after renal transplantation: impact of immunosuppressive and antihypertensive drug therapy. Clin J Am Soc Nephrol. 2006;1(3):575-582. doi:10.2215/CJN.01471005
CR  - von Düring ME, Jenssen T, Bollerslev J, et al.  Visceral fat is better related to impaired glucose metabolism than body mass index after kidney transplantation. Transpl Int. 2015;28(10):1162-1171. doi:10.1111/tri.12606
CR  - Beddhu S, Pappas LM, Ramkumar N, et al. Effects of body size and body composition on survival in hemodialysis patients. J Am Soc Nephrol. 2003;14(9):2366-2372. doi:10.1097/01.asn.0000083905.72794.e6
CR  - Eckel RH. Mechanisms of the components of the metabolic syndrome that predispose to diabetes and atherosclerotic CVD. Proc Nutrition Soc. 2007;66(1):82-95. doi:10.1017/S0029665107005320
CR  - Cosio FG, Kudva Y, van der Velde M, et al. New onset hyperglycemia and diabetes mellitus are associated with increased cardiovascular risk after kidney transplantation. Kidney Int. 2005;67(6):2415-2421. doi:10. 1111/j.1523-1755.2005.00349.x
CR  - Kanbay M, Siriopol D, Guldan M, et al. Prognostic impact of post-transplant diabetes mellitus in kidney allograft recipients: a meta-analysis. Nephrol Dial Transplant, 2025;40(3):554-576. doi:10.1093/ndt/gfae185
CR  - Frydrych LM, Fattahi F, He K, et al. Diabetes and sepsis: risk, recurrence, and ruination. Front Endocrinol (Lausanne) 2017;30:8:271. doi:10.3389/fendo.2017.00271
CR  - Unlütürk U, Yıldırım T, Savaş M, et al.  Effect of post-transplant diabetes mellitus on cardiovascular events and mortality: a single-center retrospective cohort study. Endocrine. 2024;85(2):695-703. doi:10.1007/s12020-024-03770-y
UR  - https://doi.org/10.38053/acmj.1796033
L1  - https://dergipark.org.tr/en/download/article-file/5296289
ER  -