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  • Review Article
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Risk factors for new-onset diabetes after kidney transplantation

Nature Reviews Nephrology volume 6, pages 415–423 (2010)Cite this article

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Abstract

New-onset diabetes after transplantation, a common complication following kidney transplantation, is associated with adverse patient and graft outcomes. Our understanding of the risk factors associated with this metabolic disorder is improving and both transplantation-specific and nonspecific factors are clearly involved. Knowledge of these risk factors is important so that clinicians can implement pre-emptive risk stratification strategies and to guide therapeutic, risk-attenuation approaches in patients who develop transplant-associated hyperglycemia. In this Review, we explore the current understanding of the diverse range of risk factors that contribute to abnormal glucose metabolism after transplantation, with the aim of helping to guide clinical decision-making using appropriate risk stratification.

Key Points

  • New-onset diabetes after transplantation (NODAT) is associated with adverse patient and graft outcomes

  • The pathophysiology of NODAT is similar to that of type 2 diabetes mellitus but is complicated by both transplantation-specific and nontransplantation-related risk factors

  • An understanding of nonmodifiable risk factors for NODAT can enable pre-emptive risk stratification of patients to prevent development of NODAT

  • The attenuation of modifiable risk factors for NODAT may inhibit the evolution of transplant-associated hyperglycemia and/or NODAT

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Figure 1: Pathophysiological interplay between risk factors and the development of NODAT.

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Authors and Affiliations

  1. Department of Nephrology and Transplantation, Renal Institute of Birmingham, Queen Elizabeth Hospital, Edgbaston, B15 2TH, Birmingham, UK

    Adnan Sharif

  2. Nephrology and Transplant Unit, University Hospital of Wales, Heath Park, CF14 4XW, Cardiff, UK

    Keshwar Baboolal

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Correspondence to Adnan Sharif.

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Sharif, A., Baboolal, K. Risk factors for new-onset diabetes after kidney transplantation. Nat Rev Nephrol 6, 415–423 (2010). https://doi.org/10.1038/nrneph.2010.66

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