Journal Article

Pretransplant Risk Score for New-Onset Diabetes After Kidney Transplantation

Moss, Adyr A, Weil, E. Jennifer, Reddy, Kunam S, Katariya, Nitin, Swanson, Christine M, Khamash, Hasan, Heilman, Raymond L, Knowler, William C, Mulligan, David C, Dueck, Amylou C, Chakkera, Harini A, Hamawi, Khaled

2011

Overview

OBJECTIVE: New-onset diabetes after kidney transplantation (NODAT) has adverse clinical and economic implications. A risk score for NODAT could help identify research subjects for intervention studies. RESEARCH DESIGN AND METHODS: We conducted a single-center retrospective cohort study using pretransplant clinical and laboratory measurements to construct a risk score for NODAT. NODAT was defined by hemoglobin A1c (HbA1c) ≥6.5%, fasting serum glucose ≥126 mg/dL, or prescribed therapy for diabetes within 1 year posttransplant. Three multivariate logistic regression models were constructed: 1) standard model, with both continuous and discrete variables; 2) dichotomous model, with continuous variables dichotomized at clinically relevant cut points; and 3) summary score defined as the sum of the points accrued using the terms from the dichotomous model. RESULTS: A total of 316 subjects had seven pretransplant variables with P < 0.10 in univariate logistic regression analyses (age, planned corticosteroid therapy posttransplant, prescription for gout medicine, BMI, fasting glucose and triglycerides, and family history of type 2 diabetes) that were selected for multivariate models. Areas under receiver operating curves for all three models were similar (0.72, 0.71, and 0.70). A simple risk score calculated as the sum of points from the seven variables performed as well as the other two models in identifying risk of NODAT. CONCLUSIONS: A risk score computed from seven simple pretransplant variables can identify risk of NODAT.

• Publisher: American Diabetes Association
• Subject: Adult / adverse effects / Biological and medical sciences / blood / blood glucose / body mass index / cohort studies / Diabetes / Diabetes Mellitus / Diabetes Mellitus - blood / Diabetes Mellitus - etiology / Diabetes. Impaired glucose tolerance / disease course / drug therapy / economic costs / Endocrine pancreas. Apud cells (diseases) / Endocrinopathies / etiology / Etiopathogenesis. Screening. Investigations. Target tissue resistance / fasting / Female / Glycated Hemoglobin / Glycated Hemoglobin A - metabolism / glycohemoglobin / gout / hormone supplements / Humans / Hyperglycemia / Intervention / kidney transplant / Kidney Transplantation / Kidney Transplantation - adverse effects / Logistic Models / Male / medical history / Medical sciences / medical treatment / medicine / Metabolic diseases / metabolism / Middle Aged / Miscellaneous / multivariate analysis / noninsulin-dependent diabetes mellitus / Original Research / postoperative complications / Public health. Hygiene / Public health. Hygiene-occupational medicine / Quality of life / regression analysis / Retrospective Studies / risk / risk assessment / Risk Factors / Transplants & implants / triacylglycerols / Variables / Writing