Hyperglycemia After Kidney Transplantation: Frequency and Risk Factors

Abstract

Introduction. Kidney transplantation and its conventional treatment can lead to increased risk of diabetes mellitus outbreak in normoglycemic recipients. Also, uncontrolled hyperglycemia may increase allograft loss and decrease patient survival. We aimed to assess the frequency of hyperglycemia in transplant patients and its risk factors.

Materials and Methods. A retrospective study was performed on 3342 adult kidney transplant recipients between 2008 and 2010. Demographic and laboratory data were collected. All laboratory tests were done in a one laboratory, and hyperglycemia was defined as a fasting plasma glucose level greater than 125 mg/dL.  Univariable and multivariable logistic regression analyses were used to determine the risk factors of hyperglycemia following kidney transplantation.

Results. There were 2120 men (63.4%) and 1212 women (36.3%) included in the study. The prevalence of hyperglycemia was 22.5%. Hyperglycemia was significantly higher in patients with cytomegalovirus infection (P = .001), elevated serum creatinine (P < .001), low high-density lipoprotein cholesterol (P = .01), and increased blood levels of cyclosporine (P < .001). After adjusting for covariates by multivariate logistic regression, the hyperglycemia rate was significantly higher for patients with a cyclosporine trough level greater than 250 ng/mL (P < .001), a serum creatinine level greater than 1.5 mg/dL (P < .001), and a high-density lipoprotein cholesterol less than 45 mg/dL  (P = .03).

Conclusions. This study indicated that hyperglycemia is a common metabolic disorder in Iranian kidney transplant patients. Risk factors for hyperglycemia were higher cyclosporine level, impaired kidney function, and reduced high-density lipoprotein cholesterol values.