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Pretransplant risk score for new-onset diabetes after kidney transplantation.
MedLine Citation:
PMID:  21949218     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
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 A(1c) (HbA(1c)) ≥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.
Authors:
Harini A Chakkera; E Jennifer Weil; Christine M Swanson; Amylou C Dueck; Raymond L Heilman; Kunam S Reddy; Khaled Hamawi; Hasan Khamash; Adyr A Moss; David C Mulligan; Nitin Katariya; William C Knowler
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Diabetes care     Volume:  34     ISSN:  1935-5548     ISO Abbreviation:  Diabetes Care     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-09-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7805975     Medline TA:  Diabetes Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2141-5     Citation Subset:  IM    
Affiliation:
Corresponding author: Harini A. Chakkera, chakkera.harini@mayo.edu.
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