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20-03-2024 | Kidney Transplantation | Review Article

Prevalence of new-onset diabetes mellitus after kidney transplantation: a systematic review and meta-analysis

Authors: Qiufeng Du, Tao Li, Xiaodong Yi, Shuang Song, Jing Kang, Yunlan Jiang

Abstract

Aims

Post-transplant diabetes is a prevalent and consequential complication following kidney transplantation, which significantly augments the risk of cardiovascular disease, graft loss, infection, and mortality, thereby profoundly impacting both graft and patient survival. However, the early stages of post-transplant diabetes often go unnoticed or receive inadequate management. Consequently, this study systematically assesses the incidence of new-onset diabetes after kidney transplantation with the aim to enhance medical staff awareness regarding post-transplantation diabetes and provide clinical management guidance.

Methods

We conducted a comprehensive search across multiple databases including PubMed, Web of Science, Embase, The Cochrane Library, CNKI, Wanfang, VIP, and SinoMed until September 21, 2023. Data extraction was performed using standardized tables and meta-analysis was conducted using Stata 16.0 software. A random effects model was employed to estimate the combined prevalence along with its corresponding 95% confidence interval. The source of heterogeneity was explored using subgroup analysis and sensitivity analysis, while publication bias was assessed through funnel plot and Egger's test. This study has been registered with PROSPERO under the registration number CRD42023465768.

Results

This meta-analysis comprised 39 studies with a total sample size of 16,584 patients. The prevalence of new-onset diabetes after transplantation was found to be 20% [95% CI (18.0, 22.0)]. Subgroup analyses were conducted based on age, gender, body mass index, family history of diabetes, type of kidney donor, immunosuppressive regimen, acute rejection episodes, hepatitis C infection status and cytomegalovirus infection.

Conclusions

The incidence of post-kidney transplantation diabetes is substantial, necessitating early implementation of preventive and control measures to mitigate its occurrence, enhance prognosis, and optimize patients' quality of life.

Clinical trial registration: PROSPERO: CRD42023465768.

Available only for authorised users

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Title: Prevalence of new-onset diabetes mellitus after kidney transplantation: a systematic review and meta-analysis
Authors: Qiufeng Du
Tao Li
Xiaodong Yi
Shuang Song
Jing Kang
Yunlan Jiang
Publication date: 20-03-2024
Publisher: Springer Milan
Keywords: Kidney Transplantation
Kidney Transplantation
Kidney Transplantation
Kidney Transplantation
Kidney Transplantation
Kidney Transplantation
Diabetes
Insulins
Insulins
Published in: Acta Diabetologica
Print ISSN: 0940-5429
Electronic ISSN: 1432-5233
DOI: https://doi.org/10.1007/s00592-024-02253-w

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