Pre, peri and posttransplant diabetes mellitus

Area of Science:

• Nephrology
• Endocrinology
• Immunology

Background:

• Cardiovascular events are the primary cause of mortality in chronic kidney disease (CKD) and renal transplant patients.
• Post-transplant diabetes mellitus (PTx-DM) affects 5.5-60.2% of renal allograft recipients within one year, significantly increasing cardiovascular risk.
• PTx-DM negatively impacts patient and graft outcomes and survival.

Purpose of the Study:

• To review the risk factors associated with PTx-DM in renal transplant recipients.
• To highlight the need for preventive strategies against PTx-DM.
• To discuss potential interventions for managing PTx-DM.

Main Methods:

• Review of existing literature on PTx-DM in renal transplant patients.
• Analysis of risk factors including genetics, obesity, inflammation, CKD, and immunosuppressive medications.
• Evaluation of current and potential therapeutic approaches.

Main Results:

• PTx-DM development is multifactorial, influenced by pre-existing conditions, CKD, and post-transplant medications.
• Immunosuppressive and other medications commonly used in transplant recipients can exacerbate insulin resistance and β-cell dysfunction.
• While new anti-diabetic medications show promise, a proactive preventive strategy is essential.

Conclusions:

• Targeting PTx-DM risk factors is key to developing effective prevention programs.
• Adopting non-diabetogenic immunosuppressive protocols for high-risk patients may reduce PTx-DM incidence.
• Further research into preventive strategies is needed to improve long-term outcomes for renal transplant recipients.