Risk Factors for New-Onset Diabetes in Pediatric Transplant Patients Identified

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This article is part of our ongoing coverage of Renal Week 2009. Click here for a complete list of our Renal Week Live articles.


Key Points

  • Among pediatric renal transplant recipients, increased age, a very high or very low BMI, and steroid use at the time of hospital discharge are independent factors associated with an increased risk of new-onset diabetes (NODM).
  • Older recipients had a twofold increased risk of NODM; patients with an abnormal BMI percentile had a 61% increased risk; and steroid use at discharge was associated with a 2.8 times increased risk.
  • Factors such BMI and steroid use are potentially modifiable, noted authors.

Among pediatric renal transplant recipients, increased age, a very high or very low BMI, and steroid use at the time of hospital discharge are independent factors associated with an increased risk of new-onset diabetes (NODM), according to new data presented at ASN's Renal Week 2009.

NODM after kidney transplantation is associated with inferior graft function and less-than-optimal graft and patient survival in adult renal transplant recipients. Little is known, however, about the incidence and risk for NODM in pediatric renal transplant recipients. 

Hung-Tien Kuo, MD, of Kaohsiung Medical University in Kaohsiung, Taiwan, and collaborators analyzed data obtained from the Organ Procurement and Transplantation Network/United Network for Organ Transplantation regarding 2,726 patients. NODM developed in 125 of these patients during a mean follow-up of 642 days.

Compared with recipients aged less than 10 years, older recipients had a twofold increased risk of NODM, after adjusting for other known risk factors. Patients with an abnormal BMI percentile (less than 5% and above 85%) had a 61% increased risk compared with a BMI percentile of 5% to 85%. Steroid use at discharge was associated with a 2.8 times increased risk compared with no steroid use.

The authors noted that some of these factors, such BMI and steroid use, are potentially modifiable.

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