Unexpectedly high prevalence of pretransplant abnormal glucose tolerance in pediatric kidney transplant recipients

Seiichirou Shishido, Hiroyuki Sato, Hiroshi Asanuma, Masahito Shindo, Hiroshi Hataya, Kenji Ishikura, Yuko Hamasaki, Miwa Goto, Masahiro Ikeda, Masataka Honda

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

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/m2. FPG level before transplantation was within the normal limit in all patients, while the mean HbA1C 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.

Original languageEnglish
Pages (from-to)67-73
Number of pages7
JournalPediatric Transplantation
Volume10
Issue number1
DOIs
Publication statusPublished - 2006 Feb 1
Externally publishedYes

Keywords

  • Children
  • Kidney transplantation
  • Oral glucose tolerance tests
  • Post-transplant diabetes mellitus

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Transplantation

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    Shishido, S., Sato, H., Asanuma, H., Shindo, M., Hataya, H., Ishikura, K., Hamasaki, Y., Goto, M., Ikeda, M., & Honda, M. (2006). Unexpectedly high prevalence of pretransplant abnormal glucose tolerance in pediatric kidney transplant recipients. Pediatric Transplantation, 10(1), 67-73. https://doi.org/10.1111/j.1399-3046.2006.00459.x