Date: Sunday, June 12, 2016
Session Name: Poster Session B: Kidney: Cardiovascular and Metabolic
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
Background: New onset diabetes after transplantation (NODAT) adversely impacts both allograft function and patient survival. We hypothesize that higher functional capacity prior to kidney transplant (TX) is protective against development of NODAT.
Methods: We conducted a retrospective study of non-diabetic kidney TX recipients between January 2012 and October 2015 to determine the association of pre-TX functional capacity, measured by peak oxygen uptake (VO2max) and development of NODAT. In 2012, Mayo Clinic Arizona kidney transplant program incorporated cardiopulmonary exercise testing (CPET) to estimate VO2max into the CVD screening algorithm among high-risk patients being evaluated for kidney TX. High-risk patients(>50 yrs± history of diabetes, ±history of CVD) underwent VO2max testing, if VO2max was <17ml/kg/min) MIBI scan was performed. NODAT was defined by ADA criteria: fasting blood glucose ≥126 gm/dl ± use of diabetes medications.
Results: We studied 93 of 178 kidney TX recipients with documented VO2max and non-diabetic pre-TX. Mean age = 56±12 years, 54% male, 32% with family history of DM, BMI= 28±5 kg/m[sup2]. 30 patients developed NODAT within 1 year post-TX. We compared characteristics between those who did and did not develop NODAT. Patients with NODAT were older, higher % hispanic (23% vs.6%, p<0.05), higher %black (13% vs. 8%, P<0.05), had higher fasting glucose and triglyceride. Patient BMI, gender, family history of diabetes, total cholesterol and LDL pre-TX were not significantly different between the 2 groups.
|Age, mean (yrs)||59||54||0.05|
|Sex, % female||50||44||0.54|
|Pre-TX BMI, kg/m2||28||27||0.73|
|Pre-TX fasting glucose (mg/dl)||102||94||0.02|
|Pre-TX Triglyceride (mg/dl)||209||156||0.02|
41 patients had a VO2max >17ml/kg/min. Among those only 17% (7 of 41) developed NODAT, and among the 52 patients with VO2max<17ml/kg/min, 44% (23 of 52) developed NODAT. In logistic regression analyses V02max >17ml/kg/min was significantly associated with lower risk of NODAT (OR =0.26, CI =0.10-0.69, P=0.007), this significant association persisted when adjusted for age, gender and BMI.
Conclusion: Higher functional capacity (VO2max >17ml/kg/min), conferred lower risk of NODAT. Since VO2max is a risk factor amenable to change (i.e., exercise training), these results suggest that incorporation of exercise training pre-TX could minimize development of NODAT.
CITATION INFORMATION: Qaqish I, Behmen S, Heilman R, Khamash H, Huskey J, Nair S, Chakkera H. Higher Functional Capacity Prior to Kidney Transplant Confers Lower Risk of New Onset Diabetes After Transplantation. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:Qaqish I, Behmen S, Heilman R, Khamash H, Huskey J, Nair S, Chakkera H. Higher Functional Capacity Prior to Kidney Transplant Confers Lower Risk of New Onset Diabetes After Transplantation. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/higher-functional-capacity-prior-to-kidney-transplant-confers-lower-risk-of-new-onset-diabetes-after-transplantation/. Accessed February 27, 2021.
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