Glucose metabolism after kidney transplantation

Czech version

Authors: Monika Beliančinová ¹; Udovít Laca ¹; Marián Mokáň ²; Peter Galajda ²; Ivana Dedinská ¹
Authors‘ workplace: Chirurgická klinika a transplantačné centrum JLF UK a UN Martin ¹; I. Interná klinika JLF UK a UN Martin ²
Published in: Forum Diab 2020; 9(1): 22-25
Category:

Overview

Post-transplant diabetes mellitus develops almost half of the patients by the end of the first year after kidney transplantation. Impaired glucose metabolism due to hypoglycemia is reported only in a few isolated cases of combined pancreas-kidney transplantation. The onset of hyperglycemia and diabetes mellitus has a different pathophysiology than in patients who have not undergone a solid organ transplant because of the effect of immunosuppressive therapy on pancreatic B-cell metabolism. Changing the immunosuppressive therapy with respect to pre-existing risk factors in patients may reduce the incidence of diabetes mellitus in the first year after kidney transplantation, of course, taking into account the immunological risk and the risk of developing acute graft rejection.

Keywords:

risk factors – calcineurin inhibitors – diabetes mellitus after transplantation – immunosupressive therapy

Sources

Dedinská J, Miklušica J. Základy pre odbery orgánov a transplantácie obličiek. P+M: Turany 2015: 73–74. ISBN 978–80–89694–12–9.
Hecking M, Kainz A, Werzowa J et al. Glucose Metabolism After Renal Transplantation. Diabetes Care 2013; 36(9): 2763–2771. Dostupné z DOI: <http://dx.doi.org/10.2337/dc12–2441>.
Tesař V, Vachek J. Moderní farmakoterapie v nefrologii. Maxdorf-Jessenius. Praha 2018: 214–215. ISBN 9788073455989.
Chakkera HA, Mandarino LJ. Calcineurin Inhibition and New-Onset Diabetes Mellitus After Transplantation. Transplantation 2013; 95(5): 647–652. Dostupné z DOI. <http://dx.doi.org/10.1097/TP.0b013e31826e592e>.
Wissing KM, Abramowicz D, Weekers L et al. Prospective randomized study of conversion from tacrolimus to cyclosporine A to improve glucose metabolism in patients with posttransplant diabetes mellitus after renal transplantation. Am J Transplant 2018; 18(7): 1726–1734. Dostupné z DOI: <http://dx.doi.org/10.1111/ajt.14665>.
Vergès B. mTOR and Cardiovascular Diseases: Diabetes Mellitus. Transplantation. 2018 Feb;102(2S Suppl 1): S47-S49. Dostupné z DOI: <http://dx.doi.org/10.1097/TP.0000000000001722>.
Van Laecke S, Van Biesen W, Verbeke F et al. Posttransplantation Hypomagnesemia and Its Relation with Immunosuppression as Predictors of New-Onset Diabetes after Transplantation. Am J Transplant 2009; 9(9): 2140–2149. Dostupné z DOI: <http://dx.doi.org/10.1111/j.1600–6143.2009.02752.x>.
Chakkera HA, Weil EJ, Swansonet CM et al. Pretransplant Risk Score for New-Onset Diabetes After Kidney Transplantation. Diabetes Care 2011; 34(10): 2141–2145. Dostupné z DOI: <http://dx.doi.org/10.2337/dc11–0752.>.
Dedinska I, Galajda P, Laca Ľ et al. Rizikové faktory pre diabetes mellitus po transplantácii.QuickPrint: Martin 2017: 20–21. ISBN 978–80–972594–1-9.
Graňák K, Vnučák M, Skálová P et al. Vplyv zmeny životného štýlu na vývoj potransplantačného diabetes mellitus u pacientov po transplantácii obličky. Interná med 2020; 20(2): 34–37 (v tlači).
Steddon S, Chesser A, Cunningham J et al. Oxford Handbook of Nephrology and Hypertension. 2nd ed. OUP: Oxford 2014. ISBN 9780199651610. Dostupné z DOI: <http://dx.doi.org/10.1093/med/9780199651610.001.0001>.
Chakkera HA, Weil EJ, Pham PT et al. Can New-Onset Diabetes After Kidney Transplant Be Prevented? Diabetes Care 2013; 36(5): 1406–1412. Dostupné z DOI: <http://dx.doi.org/10.2337/dc12–2067>.
Webster AC, Woodroffe RC, Taylor RS et al. Tacrolimus versus ciclosporin as primary immunosuppression for kidney transplant recipients: meta-analysis and meta-regression of randomised trial data. BMJ 2005; 331(7520): 810. Dostupné z DOI: <http://dx.doi.org/10.1136/bmj.38569.471007.AE>.
Donegan D, Hickey DP, Smith D. Hypoglycemia after Simultaneous Pancreas-Kidney Transplant Pancreas 2012; 41(6): 974–976. Dostupné z DOI: <http://dx.doi.org/10.1097/MPA.0b013e31823fb6ff>.
Semakula C, Pambuccian S, Gruessner Ret al. Clinical case seminar: hypoglycemia after pancreas transplantation: association with allograft nesidiodysplasia and expression of islet neogenesis-associated peptide. J Clin Endocrinol Metab 2002; 87(8): 3548–3554. Dostupné z DOI: <http://dx.doi.org/10.1210/jcem.87.8.8769>.
Luan FL, Stuckey LJ, Ojo AO. Abnormal Glucose Metabolism and Metabolic Syndrome in Non-Diabetic Kidney Transplant Recipients Early After Transplantation. Transplantation 2010; 89(8): 1034–1039. Dostupné z DOI: <http://dx.doi.org/10.1097/TP.0b013e3181d05a90>.