Posttransplant hyperglycemia. Increased incidence in cyclosporine-treated renal allograft recipients

David Roth, M. Milgrom, V. Esquenazi, L. Fuller, George W Burke, J. Miller

Research output: Contribution to journalArticle

156 Citations (Scopus)

Abstract

The incidence of posttransplant diabetes mellitus (PTDM) was compared in two groups of renal allograft recipients. These were all nondiabetic patients who had been transplanted between 1979 and 1987 and received either azathioprine-methylprednisolone (group 1) or cyclosporine-methylprednisolone (group 2) therapy as maintenance immunosuppression. The incidence of PTDM in group 1 was 9.1% vs. 18.6% in group 2 (P < .05). The mean daily dose of methylprednisolone during the initial 2 months posttransplant was not greater among the PTDM patients of groups 1 or 2. Cyclosporine levels and mean daily CsA doses during the initial 2 posttransplant months were also not different among the CsA-PTDM and euglycemic CsA patients. Posttransplant diabetic mellitus occurred rapidly (< 2 months) and required insulin therapy in the majority of cases. Increased age (> 40 years) was associated with a higher risk for PTDM, however, the greater incidence accompanying increased body weight only approached significance. Patients gender and donor source were not associated with signficant risk for PTDM. The development of PTDM was accompanied by a significant decrease in graft survival at 3 years in the entire PTDM population and at 4 years in the CsA-PTDM subgroup. Actuarial patients survival was not adversely affected. The current study suggests that CsA may be diabetogenic when administered with methylprednisolone to renal allograft recipients. The adverse effect on allograft survival requires further investigation. These results may also have important implications for pancreatic and islet cell transplantation.

Original languageEnglish
Pages (from-to)278-281
Number of pages4
JournalTransplantation
Volume47
Issue number2
StatePublished - Jan 1 1989

Fingerprint

Hyperglycemia
Cyclosporine
Allografts
Diabetes Mellitus
Kidney
Incidence
Methylprednisolone
Islets of Langerhans Transplantation
Cell Transplantation
Azathioprine
Graft Survival
Group Psychotherapy
Islets of Langerhans
Immunosuppression
Body Weight
Maintenance
Tissue Donors
Survival
Population

ASJC Scopus subject areas

  • Immunology
  • Transplantation

Cite this

Posttransplant hyperglycemia. Increased incidence in cyclosporine-treated renal allograft recipients. / Roth, David; Milgrom, M.; Esquenazi, V.; Fuller, L.; Burke, George W; Miller, J.

In: Transplantation, Vol. 47, No. 2, 01.01.1989, p. 278-281.

Research output: Contribution to journalArticle

Roth, D, Milgrom, M, Esquenazi, V, Fuller, L, Burke, GW & Miller, J 1989, 'Posttransplant hyperglycemia. Increased incidence in cyclosporine-treated renal allograft recipients', Transplantation, vol. 47, no. 2, pp. 278-281.
Roth, David ; Milgrom, M. ; Esquenazi, V. ; Fuller, L. ; Burke, George W ; Miller, J. / Posttransplant hyperglycemia. Increased incidence in cyclosporine-treated renal allograft recipients. In: Transplantation. 1989 ; Vol. 47, No. 2. pp. 278-281.
@article{c84494d5b3914257b5376311de6cc761,
title = "Posttransplant hyperglycemia. Increased incidence in cyclosporine-treated renal allograft recipients",
abstract = "The incidence of posttransplant diabetes mellitus (PTDM) was compared in two groups of renal allograft recipients. These were all nondiabetic patients who had been transplanted between 1979 and 1987 and received either azathioprine-methylprednisolone (group 1) or cyclosporine-methylprednisolone (group 2) therapy as maintenance immunosuppression. The incidence of PTDM in group 1 was 9.1{\%} vs. 18.6{\%} in group 2 (P < .05). The mean daily dose of methylprednisolone during the initial 2 months posttransplant was not greater among the PTDM patients of groups 1 or 2. Cyclosporine levels and mean daily CsA doses during the initial 2 posttransplant months were also not different among the CsA-PTDM and euglycemic CsA patients. Posttransplant diabetic mellitus occurred rapidly (< 2 months) and required insulin therapy in the majority of cases. Increased age (> 40 years) was associated with a higher risk for PTDM, however, the greater incidence accompanying increased body weight only approached significance. Patients gender and donor source were not associated with signficant risk for PTDM. The development of PTDM was accompanied by a significant decrease in graft survival at 3 years in the entire PTDM population and at 4 years in the CsA-PTDM subgroup. Actuarial patients survival was not adversely affected. The current study suggests that CsA may be diabetogenic when administered with methylprednisolone to renal allograft recipients. The adverse effect on allograft survival requires further investigation. These results may also have important implications for pancreatic and islet cell transplantation.",
author = "David Roth and M. Milgrom and V. Esquenazi and L. Fuller and Burke, {George W} and J. Miller",
year = "1989",
month = "1",
day = "1",
language = "English",
volume = "47",
pages = "278--281",
journal = "Transplantation",
issn = "0041-1337",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - Posttransplant hyperglycemia. Increased incidence in cyclosporine-treated renal allograft recipients

AU - Roth, David

AU - Milgrom, M.

AU - Esquenazi, V.

AU - Fuller, L.

AU - Burke, George W

AU - Miller, J.

PY - 1989/1/1

Y1 - 1989/1/1

N2 - The incidence of posttransplant diabetes mellitus (PTDM) was compared in two groups of renal allograft recipients. These were all nondiabetic patients who had been transplanted between 1979 and 1987 and received either azathioprine-methylprednisolone (group 1) or cyclosporine-methylprednisolone (group 2) therapy as maintenance immunosuppression. The incidence of PTDM in group 1 was 9.1% vs. 18.6% in group 2 (P < .05). The mean daily dose of methylprednisolone during the initial 2 months posttransplant was not greater among the PTDM patients of groups 1 or 2. Cyclosporine levels and mean daily CsA doses during the initial 2 posttransplant months were also not different among the CsA-PTDM and euglycemic CsA patients. Posttransplant diabetic mellitus occurred rapidly (< 2 months) and required insulin therapy in the majority of cases. Increased age (> 40 years) was associated with a higher risk for PTDM, however, the greater incidence accompanying increased body weight only approached significance. Patients gender and donor source were not associated with signficant risk for PTDM. The development of PTDM was accompanied by a significant decrease in graft survival at 3 years in the entire PTDM population and at 4 years in the CsA-PTDM subgroup. Actuarial patients survival was not adversely affected. The current study suggests that CsA may be diabetogenic when administered with methylprednisolone to renal allograft recipients. The adverse effect on allograft survival requires further investigation. These results may also have important implications for pancreatic and islet cell transplantation.

AB - The incidence of posttransplant diabetes mellitus (PTDM) was compared in two groups of renal allograft recipients. These were all nondiabetic patients who had been transplanted between 1979 and 1987 and received either azathioprine-methylprednisolone (group 1) or cyclosporine-methylprednisolone (group 2) therapy as maintenance immunosuppression. The incidence of PTDM in group 1 was 9.1% vs. 18.6% in group 2 (P < .05). The mean daily dose of methylprednisolone during the initial 2 months posttransplant was not greater among the PTDM patients of groups 1 or 2. Cyclosporine levels and mean daily CsA doses during the initial 2 posttransplant months were also not different among the CsA-PTDM and euglycemic CsA patients. Posttransplant diabetic mellitus occurred rapidly (< 2 months) and required insulin therapy in the majority of cases. Increased age (> 40 years) was associated with a higher risk for PTDM, however, the greater incidence accompanying increased body weight only approached significance. Patients gender and donor source were not associated with signficant risk for PTDM. The development of PTDM was accompanied by a significant decrease in graft survival at 3 years in the entire PTDM population and at 4 years in the CsA-PTDM subgroup. Actuarial patients survival was not adversely affected. The current study suggests that CsA may be diabetogenic when administered with methylprednisolone to renal allograft recipients. The adverse effect on allograft survival requires further investigation. These results may also have important implications for pancreatic and islet cell transplantation.

UR - http://www.scopus.com/inward/record.url?scp=0024592824&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0024592824&partnerID=8YFLogxK

M3 - Article

VL - 47

SP - 278

EP - 281

JO - Transplantation

JF - Transplantation

SN - 0041-1337

IS - 2

ER -