The Impact of New-Onset Diabetes After Transplantation on Survival and Major Cardiovascular Events in Korean Kidney Transplantation Recipients
1Ewha Womans University Seoul Hospital, Seoul, Korea, Republic of, 2Dongguk University Ilsan Hospital, Goyang, Korea, Republic of, 3Chung-Ang University, Seoul, Korea, Republic of, 4Seoul National University Hospital, Seoul, Korea, Republic of, 5Seoul National University College of Medicine, Seoul, Korea, Republic of, 6Informations and Statistics, Chungnam National University, Daejeon, Korea, Republic of, 7Applied Statistics, Chung-Ang University, Seoul, Korea, Republic of
Meeting: 2022 American Transplant Congress
Abstract number: 765
Keywords: Kidney, Metabolic complications
Topic: Clinical Science » Kidney » 35 - Kidney: Cardiovascular and Metabolic Complications
Session Information
Session Name: Kidney: Cardiovascular and Metabolic Complications
Session Type: Poster Abstract
Date: Saturday, June 4, 2022
Session Time: 5:30pm-7:00pm
Presentation Time: 5:30pm-7:00pm
Location: Hynes Halls C & D
*Purpose: New-onset diabetes after transplantation (NODAT) is a frequent complication in kidney transplant (KT) recipients with unfavorable outcomes, although a nationwide study on epidemiology and clinical outcome of NODAT in Korean KT recipients remain rare.
*Methods: Using the Health Insurance Review and Assessment Service of South Korea, 16719 KT recipients between 2008 and 2017 were enrolled. We excluded patients with preexisting diabetes, multi-organ transplantation, and being progressed to graft failure less than one year after KT. NODAT was defined as consecutive 30 days prescription history of antidiabetic medication after KT and cumulative incidences of NODAT were calculated. We analyzed the impact of NODAT on death censored graft failure (DCGF), death without graft failure (DWGF), and major adverse cardiovascular events (MACE) by time-dependent Cox analysis.
*Results: Among a total of 16,719 KT recipients, 10,311 were included after exclusion. Among these patients, 19.8% of recipients were diagnosed to NODAT, and 64.1% were diagnosed within 6 months after KT. NODAT patients were older, more men, having longer pre-KT dialysis vintages, and experienced more rejection episodes requiring high-dose steroids treatment after KT. During follow-up, 520 DCGF, 180 DWGF, and 213 MACE events were occurred. NODAT patients showed higher risks of DCGF (adjusted hazard ratio [aHR], 1.87; 95% confidence interval [CI], 1.52-2.3; P<0.001), DWGF (aHR 1.77; 95% CI, 1.28-2.43; P <0.001), and MACE (aHR 1.46;95% CI, 1.08-1.96; P=0.013) than patients without NODAT. In subgroup analyses according to the time of diagnosis of NODAT, the risks of DCGF and MACE were significantly higher in the late diagnosis (≥ 2 years after KT) group. When analyzed according to the use of insulin among those diagnosed with NODAT, the risks were higher in all clinical outcomes than the non-use insulin group.
*Conclusions: About 20% of diabetes-naïve KT recipients were diagnosed with NODAT with a recently increasing pattern. NODAT in KT recipients affected worse graft and patients’ outcomes as well as MACE, and these results were prominent in the group with late diagnosis of NODAT and the group using insulin.
To cite this abstract in AMA style:
Kang E, Lee J, Kang D, Jang Y, Park S, Kim Y, Kim D, Joo K, Kim Y, Park M, Lim Y, Lee H. The Impact of New-Onset Diabetes After Transplantation on Survival and Major Cardiovascular Events in Korean Kidney Transplantation Recipients [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/the-impact-of-new-onset-diabetes-after-transplantation-on-survival-and-major-cardiovascular-events-in-korean-kidney-transplantation-recipients/. Accessed November 23, 2024.« Back to 2022 American Transplant Congress