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Unexpectedly high prevalence of pretransplant abnormal glucose tolerance in pediatric kidney transplant recipients
Author(s) -
Shishido Seiichirou,
Sato Hiroyuki,
Asanuma Hiroshi,
Shindo Masahito,
Hataya Hiroshi,
Ishikura Kenji,
Hamasaki Yuko,
Goto Miwa,
Ikeda Masahiro,
Honda Masataka
Publication year - 2006
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/j.1399-3046.2006.00459.x
Subject(s) - medicine , kidney transplant , renal transplant , kidney transplantation , kidney , intensive care medicine
Several studies suggested that the incidence of new‐onset diabetes following pediatric kidney transplantation has increased markedly in recent years, with reported incidence of up to 20%. However, limited information is available regarding the incidence and features of pretransplant status of abnormal glucose tolerance in pediatric kidney transplant recipients. We assessed the risk of 55 non‐diabetic pediatric transplant recipients developing PTDM by performing OGTT prior to transplantation. For post‐transplant immunosuppression, each patient received either a CsA‐ or a TAC‐based regimen. However, recipients who had abnormal glucose tolerance in the pretransplant OGTT were allocated to the CsA‐based regimen. The mean age of the patients was 9.7 ± 5.4 yr while mean BMI was 16.5 ± 3.3 kg/m 2 . FPG level before transplantation was within the normal limit in all patients, while the mean HbA 1C value was 4.5. However, 18 of the 55 patients (32.7%) had abnormal glucose tolerance in the pretransplant OGTT, 13 (23.6%) had impaired glucose tolerance, and 5 (9.4%) had DM. PTDM developed in two patients on the TAC‐based regimen with these patients having normal glucose tolerance prior to the transplant. In contrast, the 18 patients with abnormal glucose tolerance did not develop PTDM under CsA‐based immunosuppression. Our results demonstrated an unexpectedly high prevalence of abnormal glucose tolerance in pretransplant OGTT even in a pediatric population. We believe that modification of post‐transplant immunosuppression by the identification of high‐risk patients using the pretransplant OGTT may minimize the development of new onset of PTDM.