Risk of post‐transplantation diabetes mellitus is greater in South Asian versus Caucasian kidney allograft recipients. (2nd May 2016)

• Record Type: Journal Article
• Authors: Peracha, Javeria; Nath, Jay; Ready, Andrew; Tahir, Sanna; Parekh, Krishan; Hodson, James; Ferro, Charles J.; Borrows, Richard; Sharif, Adnan
• Is Part Of: Transplant international. Volume 29:Number 6(2016)
• Page Start: 727
• Page End: 739
• Publication Date: 2016-05-02
• Subjects: ethnicity -- kidney transplant -- post‐transplantation diabetes -- type 2 diabetes; Transplantation of organs, tissues, etc -- Periodicals; 617.95405
• DOI: 10.1111/tri.12782
• Languages: English
• ISSNs: 0934-0874

Abstract

Summary: South Asians have increased risk for type 2 diabetes mellitus compared with Caucasians in the general population, but data for the development of post‐transplantation diabetes mellitus (PTDM) is scarce. In this retrospective analysis, data was extracted from electronic patient records at a single centre (2004–2014). Caucasians were more likely to be male, with higher age and BMI than South Asians. Case–control matching was therefore undertaken to remove this bias, resulting in 102 recipient pairs. Median follow‐up was 50 months (range 4–127 months). Matched groups had similar baseline characteristics, although South Asians compared with Caucasians received more deceased‐donor kidneys (74% vs. 43%, respectively, P < 0.001) and were more likely to be CMV positive (77% vs. 43%, respectively, P < 0.001). PTDM incidence was significantly higher in South Asians versus Caucasians (35% vs. 10%, respectively, subhazard ratio 4.2 [95% CI: 2.1–8.5, P < 0.001]). Donor type had significant interaction with ethnicity, with the observed difference in PTDM rates between ethnicities most visible with receipt of deceased‐donor kidneys. No significant difference was detected in allograft function, rejection episodes, adverse cardiovascular events or patient/graft survival. South Asians have increased risk of PTDM, especially recipients of deceased kidneys, and recognition of this allows appropriate patient counselling and development of targeted strategies.