Effect of Early Steroid Withdrawal on Posttransplant Diabetes Mellitus Among Kidney Transplant Recipients Differs by Recipient Age

J. Ahn¹, S. Bae¹, M. Schnitzler², G. Hess³, K. Lentine², D. Segev¹, M. McAdams-DeMarco¹

¹Johns Hopkins University, Baltimore, MD, ²Saint Louis University, St. Louis, MO, ³Drexel University, Philadelphia, PA

Meeting: 2021 American Transplant Congress

Abstract number: 928

Keywords: Immunosuppression, Kidney transplantation, Safety

Topic: Clinical Science » Kidney » Kidney Immunosuppression: Novel Regimens and Drug Minimization

Session Information

Session Name: Kidney Immunosuppression: Novel Regimens and Drug Minimization

Session Type: Poster Abstract

Session Date & Time: None. Available on demand.

Location: Virtual

*Purpose: Posttransplant diabetes mellitus (PTDM) is a major complication after kidney transplantation (KT) often attributable to immunosuppression. The risk of PTDM may increase with more potent steroid maintenance and older recipient age.

*Methods: Using USRDS data, we studied 12,488 adults (age≥18) first-time KT recipients (2010-2015) without diabetes at the time of KT. We compared the risk of PTDM among recipients underwent early steroid withdrawal (ESW) versus those continued steroid maintenance (CSM) using Cox regression with inverse probability weighting to adjust for confounding. We also tested whether the risk of PTDM resulting from CSM differed by recipient age (18-29, 30-54 and 55+ years).

*Results: Of 12,488, 28.3% recipients received ESW. The incidence rate for PTDM was 13 per 100 person-years (11 per 100 person-years in ESW; 14 per 100 person-years in CSM). Overall, ESW was associated with lower risk of PTDM compared with CSM (aHR=_0.720.79_0.86) but the risk differed by recipient age. ESW was associated with lower risk of PTDM among old (aged 55+) recipients (aHR=_0.620.71_0.81), but not among young (aged 18-29) recipients (aHR=_0.811.18_1.72, interaction p=0.01).

*Conclusions: Early immunosuppression strategy should be tailored among old recipients to balance the risks and benefits.

To cite this abstract in AMA style:

Ahn J, Bae S, Schnitzler M, Hess G, Lentine K, Segev D, McAdams-DeMarco M. Effect of Early Steroid Withdrawal on Posttransplant Diabetes Mellitus Among Kidney Transplant Recipients Differs by Recipient Age [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/effect-of-early-steroid-withdrawal-on-posttransplant-diabetes-mellitus-among-kidney-transplant-recipients-differs-by-recipient-age/. Accessed November 21, 2024.

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