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Diabetology & Metabolic Syndrome

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01-12-2021 | Kidney Transplantation | Review

Impact of diabetes mellitus developing after kidney transplantation on patient mortality and graft survival: a meta-analysis of adjusted data

Authors: Hailing Lin, Jiqiang Yan, Lei Yuan, Beibei Qi, Zhujing Zhang, Wanlu Zhang, Aihua Ma, Fuwan Ding

Published in: Diabetology & Metabolic Syndrome | Issue 1/2021

Abstract

Background

Post-transplant diabetes mellitus (PTDM) occurs in 10–30% of kidney transplant recipients. However, its impact on mortality and graft survival is still ambiguous. Therefore, the current study aimed to analyze if PTDM increases mortality and graft failure by pooling multivariable-adjusted data from individual studies.

Methods

PubMed, Embase, and CENTRAL, and Google Scholar were searched for studies comparing mortality and graft failure between PTDM and non-diabetic patients. Multivariable-adjusted hazard ratios (HR) were pooled in a random-effects model.

Results

Fourteen retrospective studies comparing 9872 PTDM patients with 65,327 non-diabetics were included. On pooled analysis, we noted a statistically significant increase in the risk of all-cause mortality in patients with PTDM as compared to non-diabetics (HR: 1.67 95% CI 1.43, 1.94 I² = 57% p < 0.00001). The meta-analysis also indicated a statistically significant increase in the risk of graft failure in patients with PTDM as compared to non-diabetics (HR: 1.35 95% CI 1.15, 1.58 I² = 78% p = 0.0002). Results were stable on sensitivity analysis. There was no evidence of publication bias on funnel plots.

Conclusion

Kidney transplant patients developing PTDM have a 67% increased risk of all-cause mortality and a 35% increased risk of graft failure. Further studies are needed to determine the exact cause of increased mortality and the mechanism involved in graft failure.

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Title: Impact of diabetes mellitus developing after kidney transplantation on patient mortality and graft survival: a meta-analysis of adjusted data
Authors: Hailing Lin
Jiqiang Yan
Lei Yuan
Beibei Qi
Zhujing Zhang
Wanlu Zhang
Aihua Ma
Fuwan Ding
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Kidney Transplantation
Kidney Transplantation
Kidney Transplantation
Kidney Transplantation
Kidney Transplantation
Diabetes
Kidney Transplantation
Published in: Diabetology & Metabolic Syndrome / Issue 1/2021
Electronic ISSN: 1758-5996
DOI: https://doi.org/10.1186/s13098-021-00742-4

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