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KMID : 1141520230380010139
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Endocrinology and Metabolism
2023 Volume.38 No. 1 p.139 ~ p.145
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Impact of Post-Transplant Diabetes Mellitus on Survival and Cardiovascular Events in Kidney Transplant Recipients
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Jeon Ja-Young
Shin Han-Bit
Park Bum-Hee
Lee Na-Mi
Kim Hae-Jin
Kim Dae-Jung
Lee Kwan-Woo
Han Seung-Jin
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Abstract
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Background: Post-transplant diabetes mellitus (PTDM) is a risk factor for poor outcomes after kidney transplantation (KT). However, the outcomes of KT have improved recently. Therefore, we investigated whether PTDM is still a risk factor for mortality, majoratherosclerotic cardiovascular events (MACEs), and graft failure in KT recipients.
Methods: We studied a retrospective cohort of KT recipients (between 1994 and 2017) at a single tertiary center, and compared therates of death, MACEs, overall graft failure, and death-censored graft failure after KT between patients with and without PTDM using Kaplan-Meier analysis and a Cox proportional hazard model.
Results: Of 571 KT recipients, 153 (26.8%) were diagnosed with PTDM. The mean follow-up duration was 9.6 years. In the Kaplan-Meier analysis, the PTDM group did not have a significantly increased risk of death or four-point MACE compared with thenon-diabetes mellitus group (log-rank test, P=0.957 and P=0.079, respectively). Multivariate Cox proportional hazard modelsshowed that PTDM did not have a negative impact on death or four-point MACE (P=0.137 and P=0.181, respectively). In addition,PTDM was not significantly associated with overall or death-censored graft failure. However, patients with a long duration ofPTDM had a higher incidence of four-point MACE.
Conclusion: Patient survival and MACEs were comparable between groups with and without PTDM. However, PTDM patientswith long duration diabetes were at higher risk of cardiovascular disease.
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KEYWORD
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Kidney transplantation, Diabetes mellitus, Cardiovascular diseases, Mortality, Graft survival
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