Posttransplant diabetes mellitus in pediatric renal transplant recipients

A report of The North American Pediatric Renal Transplant Cooperative Study (NAPRTCS)

Amira Al-Uzri*, Donald M. Stablein, Richard A Cohn

*Corresponding author for this work

Research output: Contribution to journalArticle

89 Citations (Scopus)

Abstract

Background. The incidence of renal post transplant diabetes mellitus (PTDM) in adults varies from 3-46%. Methods. We did a retrospective analysis of 1365 children in The North American Pediatric Renal Transplant Cooperative Study with renal transplant (Tx) reported between January 92 and July 1997. PTDM, defined as >2 weeks of insulin therapy after Tx, developed in 36 patients. A control group of 153/1329 non-PTDM patients was selected and matched for age at Tx and primary diagnosis. Results. African-Americans were overrepresented (36.1 vs. 17.6%, P=0.017) and Hispanics were underrepresented (5.6 vs. 26.1%, P=0.019) among cases. Although prednisone dose 30 days post-Tx was higher among cases (0.89 mg/kg/day) versus controls (0.71 mg/kg/day), P=0.019, cyclosporine dose was similar. No differences in prednisone or cyclosporine doses were observed at 6, 12, or 24 months post-Tx. Tacrolimus use in PTDM group was high (45%). The estimated incidence of first acute rejection at 1, 3, and 12 months was higher among cases, 0.41±0.08, 0.52±0.08, 0.61±0.08, compared to controls, 0.23±0.02, 0.37±0.02, and 47±0.02 (P=0.058). Crude graft failure rates of 13.5% (5/36) and 12.4% (19/153) were similar between the two groups, so was the calculated creatinine clearance at 12 and 24 months and post-Tx hospitalization days. Conclusion. PTDM occurs in <3% of children. African-Americans are at higher risk and Hispanics at lower risk for PTDM. Tacrolimus is a significant risk factor for PTDM. Children with PTDM had a higher incidence of acute rejection, but graft survival, kidney function, and hospitalization rates were similar to selected controls.

Original languageEnglish (US)
Pages (from-to)1020-1024
Number of pages5
JournalTransplantation
Volume72
Issue number6
DOIs
StatePublished - Sep 27 2001

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Diabetes Mellitus
Pediatrics
Transplants
Kidney
Tacrolimus
Prednisone
Hispanic Americans
African Americans
Cyclosporine
Incidence
Hospitalization
Transplant Recipients
Graft Survival
Creatinine
Insulin
Control Groups

ASJC Scopus subject areas

  • Transplantation

Cite this

@article{5cfbbc12668b4ab791de1336e2626214,
title = "Posttransplant diabetes mellitus in pediatric renal transplant recipients: A report of The North American Pediatric Renal Transplant Cooperative Study (NAPRTCS)",
abstract = "Background. The incidence of renal post transplant diabetes mellitus (PTDM) in adults varies from 3-46{\%}. Methods. We did a retrospective analysis of 1365 children in The North American Pediatric Renal Transplant Cooperative Study with renal transplant (Tx) reported between January 92 and July 1997. PTDM, defined as >2 weeks of insulin therapy after Tx, developed in 36 patients. A control group of 153/1329 non-PTDM patients was selected and matched for age at Tx and primary diagnosis. Results. African-Americans were overrepresented (36.1 vs. 17.6{\%}, P=0.017) and Hispanics were underrepresented (5.6 vs. 26.1{\%}, P=0.019) among cases. Although prednisone dose 30 days post-Tx was higher among cases (0.89 mg/kg/day) versus controls (0.71 mg/kg/day), P=0.019, cyclosporine dose was similar. No differences in prednisone or cyclosporine doses were observed at 6, 12, or 24 months post-Tx. Tacrolimus use in PTDM group was high (45{\%}). The estimated incidence of first acute rejection at 1, 3, and 12 months was higher among cases, 0.41±0.08, 0.52±0.08, 0.61±0.08, compared to controls, 0.23±0.02, 0.37±0.02, and 47±0.02 (P=0.058). Crude graft failure rates of 13.5{\%} (5/36) and 12.4{\%} (19/153) were similar between the two groups, so was the calculated creatinine clearance at 12 and 24 months and post-Tx hospitalization days. Conclusion. PTDM occurs in <3{\%} of children. African-Americans are at higher risk and Hispanics at lower risk for PTDM. Tacrolimus is a significant risk factor for PTDM. Children with PTDM had a higher incidence of acute rejection, but graft survival, kidney function, and hospitalization rates were similar to selected controls.",
author = "Amira Al-Uzri and Stablein, {Donald M.} and Cohn, {Richard A}",
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Posttransplant diabetes mellitus in pediatric renal transplant recipients : A report of The North American Pediatric Renal Transplant Cooperative Study (NAPRTCS). / Al-Uzri, Amira; Stablein, Donald M.; Cohn, Richard A.

In: Transplantation, Vol. 72, No. 6, 27.09.2001, p. 1020-1024.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Posttransplant diabetes mellitus in pediatric renal transplant recipients

T2 - A report of The North American Pediatric Renal Transplant Cooperative Study (NAPRTCS)

AU - Al-Uzri, Amira

AU - Stablein, Donald M.

AU - Cohn, Richard A

PY - 2001/9/27

Y1 - 2001/9/27

N2 - Background. The incidence of renal post transplant diabetes mellitus (PTDM) in adults varies from 3-46%. Methods. We did a retrospective analysis of 1365 children in The North American Pediatric Renal Transplant Cooperative Study with renal transplant (Tx) reported between January 92 and July 1997. PTDM, defined as >2 weeks of insulin therapy after Tx, developed in 36 patients. A control group of 153/1329 non-PTDM patients was selected and matched for age at Tx and primary diagnosis. Results. African-Americans were overrepresented (36.1 vs. 17.6%, P=0.017) and Hispanics were underrepresented (5.6 vs. 26.1%, P=0.019) among cases. Although prednisone dose 30 days post-Tx was higher among cases (0.89 mg/kg/day) versus controls (0.71 mg/kg/day), P=0.019, cyclosporine dose was similar. No differences in prednisone or cyclosporine doses were observed at 6, 12, or 24 months post-Tx. Tacrolimus use in PTDM group was high (45%). The estimated incidence of first acute rejection at 1, 3, and 12 months was higher among cases, 0.41±0.08, 0.52±0.08, 0.61±0.08, compared to controls, 0.23±0.02, 0.37±0.02, and 47±0.02 (P=0.058). Crude graft failure rates of 13.5% (5/36) and 12.4% (19/153) were similar between the two groups, so was the calculated creatinine clearance at 12 and 24 months and post-Tx hospitalization days. Conclusion. PTDM occurs in <3% of children. African-Americans are at higher risk and Hispanics at lower risk for PTDM. Tacrolimus is a significant risk factor for PTDM. Children with PTDM had a higher incidence of acute rejection, but graft survival, kidney function, and hospitalization rates were similar to selected controls.

AB - Background. The incidence of renal post transplant diabetes mellitus (PTDM) in adults varies from 3-46%. Methods. We did a retrospective analysis of 1365 children in The North American Pediatric Renal Transplant Cooperative Study with renal transplant (Tx) reported between January 92 and July 1997. PTDM, defined as >2 weeks of insulin therapy after Tx, developed in 36 patients. A control group of 153/1329 non-PTDM patients was selected and matched for age at Tx and primary diagnosis. Results. African-Americans were overrepresented (36.1 vs. 17.6%, P=0.017) and Hispanics were underrepresented (5.6 vs. 26.1%, P=0.019) among cases. Although prednisone dose 30 days post-Tx was higher among cases (0.89 mg/kg/day) versus controls (0.71 mg/kg/day), P=0.019, cyclosporine dose was similar. No differences in prednisone or cyclosporine doses were observed at 6, 12, or 24 months post-Tx. Tacrolimus use in PTDM group was high (45%). The estimated incidence of first acute rejection at 1, 3, and 12 months was higher among cases, 0.41±0.08, 0.52±0.08, 0.61±0.08, compared to controls, 0.23±0.02, 0.37±0.02, and 47±0.02 (P=0.058). Crude graft failure rates of 13.5% (5/36) and 12.4% (19/153) were similar between the two groups, so was the calculated creatinine clearance at 12 and 24 months and post-Tx hospitalization days. Conclusion. PTDM occurs in <3% of children. African-Americans are at higher risk and Hispanics at lower risk for PTDM. Tacrolimus is a significant risk factor for PTDM. Children with PTDM had a higher incidence of acute rejection, but graft survival, kidney function, and hospitalization rates were similar to selected controls.

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