New-onset diabetes mellitus after transplantation and predisposing factors in kidney transplant recipients

Kidney transplant is the most ideal treatment for end stage renal failure. Various immunosuppressive treatment regimens are applied to prevent graft rejection in kidney transplant recipients. Metabolic side effects can be observed due to immunosupressive drugs. Various risk factors contribute to these metabolic side effects. In our study, clinical and biochemical risk factors that may be effective in the development of new onset diabetes after transplantation - New Onset Diabetes Mellitus After Transplantation (NODAT), with the new definition Post Transplantation Diabetes Mellitus (PTDM), were investigated. In this study 120 kidney transplant patients who did not have diabetes mellitus before, were included. We investigated the relationship between clinical and laboratory parameters on the 0th, 1st, 3rd, 6th, 12th month of our kidney transplant recipients who developed or did not develop PTDM. PTDM has been observed in 29.1% of our kidney transplant recipients and in %80 of the PTDM patients DM developed in the first three months. As follow-up time extends, the risk of developing PTDM was decreased by %27. No significant relationship was found between the risk of developing PTDM and gender, body mass index, donor type and donor age, pretransplant lipid values, preemptive transplantation, previous dialysis type and type of induction therapy. The risk of developing PTDM was found to be 5.24 times higher in the group with diabetic family history, 2.55 times higher in the group using beta blocker drugs and % 4.4 times higher in elderly people. Serum magnesium and potassium levels were different only in the 1. month between the PTDM group and non-PTDM group. All other labarotary parameters were found to be similar. In 2 year follow-up period any negative effect of diabetes mellitus on GFR was not determined. As a result; diabetic family history, advanced age, and using beta blocker can cause PTDM development. The risk of developing PTDM higher in the first three months after transplantation and hipomagnesemia in the first month after transplantation can play important role on the developing PTDM. Keywords: Renal transplantation, Post-transplantation Diabetes Mellitus, Hipomagnesemia