Pretransplant risk score for new-onset diabetes after kidney transplantation

Harini A. Chakkera*, E. Jennifer Weil, Christine M. Swanson, Amylou C. Dueck, Raymond L. Heilman, Kunam S. Reddy, Khaled Hamawi, Hasan Khamash, Adyr A. Moss, David C. Mulligan, Nitin Katariya, William C. Knowler

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

48 Scopus citations

Abstract

OBJECTIVE - New-onset diabetes after kidney transplantation (NODAT) has adverse clinical and economic implications. A risk score for NODAT could help identify research subjects for intervention studies. RESEARCH DESIGN AND METHODS - We conducted a single-center retrospective cohort study using pretransplant clinical and laboratory measurements to construct a risk score for NODAT. NODAT was defined by hemoglobin A 1c (HbA 1c) ≥6.5%, fasting serum glucose ≥126mg/dL, or prescribed therapy for diabetes within 1 year posttransplant. Three multivariate logistic regression models were constructed: 1) standard model, with both continuous and discrete variables; 2) dichotomous model, with continuous variables dichotomized at clinically relevant cut points; and 3) summary score defined as the sum of the points accrued using the terms from the dichotomous model. RESULTS - A total of 316 subjects had seven pretransplant variables with P < 0.10 in univariate logistic regression analyses (age, planned corticosteroid therapy posttransplant, prescription for gout medicine, BMI, fasting glucose and triglycerides, and family history of type 2 diabetes) that were selected for multivariate models. Areas under receiver operating curves for all three models were similar (0.72, 0.71, and 0.70). A simple risk score calculated as the sum of points from the seven variables performed as well as the other two models in identifying risk of NODAT. CONCLUSIONS - A risk score computed from seven simple pretransplant variables can identify risk of NODAT.

Original languageEnglish (US)
Pages (from-to)2141-2145
Number of pages5
JournalDiabetes care
Volume34
Issue number10
DOIs
StatePublished - Oct 2011

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

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