| Relationship between inpatient hyperglycemia and insulin treatment after kidney transplantation and future new onset diabetes mellitus. | |
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MedLine Citation:
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PMID: 20558559 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND AND OBJECTIVES: Approximately two-thirds of kidney transplant recipients with no previous history of diabetes experience inpatient hyperglycemia immediately after kidney transplant surgery; whether inpatient hyperglycemia predicts future new onset diabetes after transplant (NODAT) is not established. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: A retrospective study was conducted to determine the risk conferred by inpatient hyperglycemia on development of NODAT within 1 year posttransplant. All adult nondiabetic kidney transplant recipients between June 1999 and January 2008 were included. Posttransplant inpatient hyperglycemia was defined as any bedside capillary blood glucose > or = 200 mg/dl or insulin therapy during hospitalization. NODAT was defined as HbA1C > or = 6.5%, fasting venous serum glucose > or = 126 mg/dl, or prescribed diet or medical therapy for diabetes mellitus. RESULTS: The study cohort included 377 patients. NODAT developed in 1 (4%) of the 28 patients without inpatient hyperglycemia, 4 (18%) of the 22 patients with inpatient hyperglycemia but not treated with insulin, and in 98 (30%) of the 327 of the patients who were diagnosed with inpatient hyperglycemia and were treated with insulin. In adjusted analyses, requirement of insulin therapy during hospitalization posttransplant was associated with a 4-fold increase in NODAT (relative risk 4.01; confidence interval, 1.49 to 10.7; P = 0.006). CONCLUSION: Development of inpatient hyperglycemia after kidney transplantation in nondiabetic patients significantly increased the risk of NODAT. Additionally, we observed a significantly increased risk of cardiovascular events in patients who developed NODAT. |
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Authors:
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Harini A Chakkera; William C Knowler; Yugandhara Devarapalli; E Jennifer Weil; Raymond L Heilman; Amylou Dueck; David C Mulligan; Kunam S Reddy; Adyr A Moss; Kristin L Mekeel; Marek J Mazur; Khaled Hamawi; Janna C Castro; Curtiss B Cook |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural Date: 2010-06-17 |
Journal Detail:
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Title: Clinical journal of the American Society of Nephrology : CJASN Volume: 5 ISSN: 1555-905X ISO Abbreviation: Clin J Am Soc Nephrol Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-09-08 Completed Date: 2011-01-11 Revised Date: 2011-09-13 |
Medline Journal Info:
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Nlm Unique ID: 101271570 Medline TA: Clin J Am Soc Nephrol Country: United States |
Other Details:
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Languages: eng Pagination: 1669-75 Citation Subset: IM |
Affiliation:
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Division of Nephrology, Mayo Clinic Hospital, Phoenix, AZ 85054, USA. chakkera.harini@mayo.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Arizona Biological Markers / blood Blood Glucose / metabolism Cardiovascular Diseases / etiology Chi-Square Distribution Diabetes Mellitus / blood, etiology*, therapy Female Hemoglobin A, Glycosylated / metabolism Humans Hyperglycemia / blood, drug therapy*, etiology* Hypoglycemic Agents / therapeutic use* Inpatients* Insulin / therapeutic use* Kidney Transplantation / adverse effects* Logistic Models Male Middle Aged Risk Assessment Risk Factors Time Factors |
| Grant Support | |
ID/Acronym/Agency:
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1 KL2 RR024151/RR/NCRR NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers; 0/Blood Glucose; 0/Hemoglobin A, Glycosylated; 0/Hypoglycemic Agents; 0/hemoglobin A1c protein, human; 11061-68-0/Insulin |
| Comments/Corrections | |
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