04 February 2019 : Original article
New-Onset Diabetes After Renal Transplantation (NODAT): Is It a Risk Factor for Renal Cell Carcinoma or Renal Failure?
Haibo Nie1AE*, Wei Wang1BCD, Yongbin Zhao1BC, Xiaoming Zhang1CE, Yuansong Xiao1BC, Qinsong Zeng12G, Changzhen Zhang1E, Lei Zhang1EDOI: 10.12659/AOT.909099
Ann Transplant 2019; 24:62-69
Abstract
BACKGROUND: Diabetes mellitus (DM) is a risk factor for renal failure and possibly for renal cell carcinoma (RCC). Post-transplantation DM occurs frequently after solid organ transplantation. We investigated whether new-onset diabetes after renal transplantation (NODAT) is a risk factor for RCC or renal failure.
MATERIAL AND METHODS: Data of 96,699 discharged patients with and without NODAT were extracted from the 2005–2014 Nationwide Inpatient Sample (NIS) database, after excluding patients with DM diagnosed at least 1 year prior to renal transplantation. Main outcomes were RCC diagnosis less than 1-year post-transplantation, RCC stage, and renal failure. Univariate and multivariate regression analyses were performed to identify demographic and clinical factors associated with post-transplantation RCC or renal failure.
RESULTS: Significant differences were found in age and race between patients with and without NODAT (both P<0.001). The renal failure rate was 0.8% (n=1) in NODAT patients and 0.3% (n=314) in those without NODAT. Older age (OR, 1.030; 95% CI: 1.023 to 1.036), male (OR, 1.872; 95% CI: 1.409 to 2.486), Black (OR, 2.199; 95% CI: 1.574 to 3.071) and hospitalization in urban teaching hospitals were associated with increased risk of RCC.
CONCLUSIONS: Analysis of over 90,000 NIS hospitalizations with diagnosis-coded kidney transplantation suggested that NODAT may not be an independent risk factor for RCC and renal failure.
Keywords: Kidney Neoplasms, Kidney Transplantation, Neurology, Carcinoma, Renal Cell, Cross-Sectional Studies, Diabetes Mellitus, Postoperative Complications, renal insufficiency, Risk Factors
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