Investigation of the effect of changes in magnesium level on the glucose metabolism after kidney transplantation

In this study we aimed to investigate the correlation between the post op magnesium levels and the changes in the levels of the glucose and insulin after the kidney transplantation; and the effects of the immunsupresive drugs to these parameters. Study included 38 patients (14 women, 24 men) who have undergone a kidney transplantation. Patients' Mg, glucose, insulin and insulin resistance (HOMA-IR) levels had been measured and recorded for 3 months. Patients were divided into two groups (Tacrolimus-TAC and Siklosporin-CsA). The Mg levels of all patients signaficantly decreased in compared to basal serum levels of Mg. On the other hand there are no differences between the levels of the first and third month measures. The magnesium levels of the CsA and TAC groups signaficantly decreased in compared to their pre op measures. The decrease of the TAC group post op serum Mg level measures in the first month and the third month were greater than the decrease in the levels of the CsA group. Frequency of hypomagnesemia were detected as 5.3% in pre-op measures, in the first month as 81.6%, in the third month as 78.9%. TAC group's the third month post-op hypomagnesemia ratio (85.5%) was greater than CsA group's ratio (58.3) (p=0.034) Significant increases were detected on post-op İnsulin and Homeostasis model assesment insulin resistance (HOMA-IR) values, but there were not meaningfull changes in prepirandial blood glucose levels. Only TAC group's serum insulin, Prepirandial blood glocose level and HOMA-IR values were significantly increased in the post-op third month in comparison with the pre-op values. TAC group's post-op third month glucose levels were signaficantly increased in compared to CsA group (-7.2% to 8.4%, p=0.046). But, the changes of both two groups' insulin and HOMA-IR levels in the third month were similar. The number of patients with insulin resistance in TAC group increased from 11.5% (preop) to 50% (post op). On the other hand, the number of the CsA group patients with insulin resistance decreased from 50% to 33.3%. İn conclusion, frequency of hyperglisemia, İnsulin resistance and hypomagnesimia were increased after kidney transplantation. Hypomagnesimia was observed to be more common in TAC group than CsA group. According to our study, increase in frequency of hyperglisemia, İnsulin resistance and hypomagnesimia after the kidney transplatation could be related with Tacralimus use. Keywords: Kidney transplantation, Hypomagnesemia, Calcineurin inhibitor, Insulin Resistance, Diabetes Mellitus