PRAGUE—Diuretic use and smoking are modifiable risk factors associated with the development of new-onset diabetes (NODAT) after renal transplantation, according to investigators Emilio Rodrigo, MD, of Hospital Universitario Marqués de Valdecilla, Santander, Spain, and colleagues who studied 303 adult kidney transplant recipients without a history of diabetes.

The researchers defined first-year and long-term NODAT as a fasting plasma glucose level (FPG) of 126 mg/dL or higher, confirmed by repeat testing on different days. They did not consider transient elevated FPG during the first three months to be NODAT.

NODAT developed in 37 patients (12.2%) in the first year post-transplant. The incidence of NODAT among patients taking diuretics was 20.2% and 24.7% at one and five years, respectively, compared with 10.5% and 13.3% among patients who did not use diuretics, the researchers. Diuretic use and smoking each were associated with a 2.5 times increased risk for first-year NODAT independent of other variables.

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A family history of diabetes increased the risk by 3.5-fold. The risk also increased with recipient age.

Previous research has shown that immunosuppressive drugs account for 74% of the risk for NODAT development, the authors pointed out.