| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Departments of * Nephrology and Endocrinology and School of Population Health, University of Queensland at Princess Alexandra Hospital, Brisbane, Queensland, Australia
Address correspondence to: Dr. Kirsten Armstrong, Department of Nephrology, Level 2 Ambulatory Renal and Transplant Services Building, Princess Alexandra Hospital, Ipswich Road, Brisbane Qld 4102, Australia. Phone: +61-7-3240-5080; Fax: +60-7-3240-5480; kirsty{at}ascom.net
Posttransplantation diabetes (PTD) contributes to cardiovascular disease and graft loss in renal transplant recipients (RTR). Current recommendations advise fasting blood glucose (FBG) as the screening and diagnostic test of choice for PTD. This study sought to determine (1) the predictive power of FBG with respect to 2-h blood glucose (2HBG) and (2) the prevalence of PTD using FBG and 2HBG compared with that using FBG alone, in prevalent RTR. A total of 200 RTR (mean age 52 yr; 59% male; median transplant duration 6.6 yr) who were >6 mo posttransplantation and had no known history of diabetes were studied. Patients with FBG <126 mg/dl (7.0 mmol/L; n = 188) underwent an oral glucose tolerance test (OGTT). Receiver operating characteristic analyses evaluated the optimal level of FBG predictive of PTD (2HBG 
200 mg/dl [11.1 mmol/L]) and impaired glucose tolerance (IGT; 2HBG 140 to 200 mg/dl [7.8 to 11.0 mmol/L]). An abnormal OGTT was reported in 79 (42%) nondiabetic RTR: PTD (n = 22) and IGT (n = 57). The optimal FBG that was predictive of PTD was 101 mg/dl (5.6 mmol/L; area under the curve 0.70; sensitivity 64%, specificity 67%, positive predictive value 20%, negative predictive value 93%). The optimal FBG that was predictive of IGT was less well defined (area under the curve 0.54). The prevalence of PTD was higher by OGTT than by FBG alone (17 versus 6%; P < 0.001). FBG may not be the optimal screening or diagnostic tool for PTD or IGT in RTR. Consideration should be given to introducing the OGTT as a routine posttransplantation investigation, although the implications of a pathologic OGTT are still to be determined in this population.
This article has been cited by other articles:
|
|
 |
|
  H. W. Chan, C. Y. Cheung, Y. L. Liu, Y. H. Chan, H. S. Wong, W. L. Chak, K. S. Choi, K. F. Chau, and C. S. Li Prevalence of abnormal glucose metabolism in Chinese renal transplant recipients: a single centre study Nephrol. Dial. Transplant., October 1, 2008; 23(10): 3337 - 3342. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Delgado, J. M. Diaz, I. Silva, J. M. Osorio, A. Osuna, B. Bayes, R. Lauzurica, E. Arellano, J. M. Campistol, R. Dominguez, et al. Unmasking Glucose Metabolism Alterations in Stable Renal Transplant Recipients: A Multicenter Study Clin. J. Am. Soc. Nephrol., May 1, 2008; 3(3): 808 - 813. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. C. Shirali and M. J. Bia Management of Cardiovascular Disease in Renal Transplant Recipients Clin. J. Am. Soc. Nephrol., March 1, 2008; 3(2): 491 - 504. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. D. Bloom and M. F. Crutchlow New-Onset Diabetes Mellitus in the Kidney Recipient: Diagnosis and Management Strategies Clin. J. Am. Soc. Nephrol., March 1, 2008; 3(Supplement_2): S38 - S48. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
