التفاصيل البيبلوغرافية
| العنوان: |
The impact of early-diagnosed new-onset post-transplantation diabetes mellitus on survival and major cardiac events. |
| المؤلفون: |
Hjelmesæth, J.1 joran@online.no, Hartmann, A.1, Leivestad, T.2, Holdaas, H.1, Sagedal, S.1, Olstad, M.3, Jenssen, T.1 |
| المصدر: |
Kidney International. Feb2006, Vol. 69 Issue 3, p588-595. 8p. 1 Diagram, 4 Charts, 2 Graphs. |
| مصطلحات موضوعية: |
*DIABETES, *KIDNEY transplantation, *CARDIOVASCULAR diseases, *BLOOD circulation disorders, *DISEASE risk factors, *CYTOMEGALOVIRUS diseases, *PATIENTS |
| مستخلص: |
The impact of early-diagnosed new-onset post-transplantation diabetes mellitus (PTDM) on cardiovascular (CV) disease is not well described. The objectives of the present prospective single-center observational study were to assess the long-term effects of early-diagnosed new-onset PTDM on major cardiac events (MCE; cardiac death or nonfatal acute myocardial infarction) and patient survival. Diabetic status and CV risk factors were assessed in 201 consecutive renal allograft recipients 3 months after transplantation (baseline) during a period of 16 months (1995–96). Follow-up data until January 1, 2004 were obtained from the Norwegian Renal Registry. The 8-year (range 7–9 years) cumulative incidence of MCEs was 7% (nine out of 138) in recipients without diabetes, 20% (seven out of 35) in patients with new-onset PTDM and 21% (six out of 28) in patients with diabetes mellitus before transplantation (DM). Proportional hazards regression analyses (forward stepwise regression) revealed that patients with PTDM had an approximately three-fold increased risk of MCEs as compared with nondiabetic patients (hazard ratio (HR)=3.27, 95% confidence interval (CI)=1.22–8.80, P=0.019). A total of 61 patients (30%) died. Eight-year patient survival was 80% in the nondiabetic group, 63% in the PTDM group and 29% in the DM group, respectively. Pretransplant diabetes (HR=5.09, 95% CI=2.60–9.96, P<0.001), age (HR=1.03, 95% CI=1.01–1.05, P=0.016), cytomegalovirus (CMV) infection (HR=2.66, 95% CI=1.27–5.53, P=0.009), and creatinine clearance (HR=0.98, 95% CI=0.96–1.00, P=0.046), but not PTDM (HR=1.20, 95% CI=0.58–2.49, P=0.621), were independent predictors of death in the multiple Cox regression model. Early-diagnosed PTDM is a predictor of MCEs, but not of all-cause mortality, the first 8 years after renal transplantation.Kidney International (2006) 69, 588–595. doi:10.1038/sj.ki.5000116; published online 4 January 2006 [ABSTRACT FROM AUTHOR] |
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