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New onset diabetes after transplantation (NODAT): an overview

Phuong-Thu T Pham1, Phuong-Mai T Pham, Son V Pham

  • 1Nephrology Division, Kidney Transplant Program, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA;

Diabetes, Metabolic Syndrome and Obesity : Targets and Therapy
|July 16, 2011
PubMed

Insights

New onset diabetes mellitus after transplantation (NODAT) is a common complication that increases cardiovascular risks and reduces survival in kidney transplant recipients. Early identification and management of NODAT are crucial for improving patient and graft outcomes.

Area of Science:

  • Nephrology
  • Transplantation Immunology
  • Endocrinology

Background:

  • Renal transplantation improves cardiovascular risk factors but introduces new risks like diabetes, hypertension, and dyslipidemia.
  • Immunosuppressive drugs (e.g., calcineurin inhibitors, corticosteroids, mTOR inhibitors) contribute to these post-transplant complications.
  • New onset diabetes mellitus after transplantation (NODAT) is a frequent and serious complication.

Purpose of the Study:

  • To review the diagnostic criteria, incidence, risk factors, and pathogenic mechanisms of NODAT.
  • To discuss the impact of NODAT on patient and graft outcomes.
  • To suggest guidelines for early identification and management of NODAT.

Main Methods:

  • Literature review of diagnostic criteria for NODAT.
  • Analysis of incidence rates across solid organ transplantation.
  • Examination of risk factors and pathogenic pathways.
  • Evaluation of NODAT's impact on patient survival, graft rejection, and cardiovascular events.

Main Results:

  • NODAT incidence varies widely (2%–53%) across solid organ transplants.
  • NODAT is associated with increased cardiovascular events, infection, and reduced patient/graft survival.
  • Specific immunosuppressive agents are implicated in NODAT development.

Conclusions:

  • NODAT poses significant risks to kidney transplant recipients.
  • Identifying high-risk patients and implementing preventative strategies are essential.
  • Effective management of NODAT can improve long-term patient and allograft outcomes.
Keywords:
cyclosporinecytomegalovirus and diabeteshepatitis C and diabetesnew onset diabetes after transplantation (NODAT)sirolimustacrolimus

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