Incidence of Diabetes After Kidney Transplant Increasing

An increasing number of people appear to be developing diabetes for the first time after kidney transplant, increasing their risk of transplant complications and death, according to a Sept 2, 2004, news release from the National Kidney Foundation. Moreover, people with pre-existing diabetes appear to benefit more from kidney transplantation when it is performed before they develop kidney failure, suggesting that physicians should provide the option of transplantation to patients with diabetes sooner rather than later.

As part of a recent study, more than 60 experts, including physicians, surgeons, nurses, and allied health professionals, met to discuss state-of-the-art approaches to treating patients who have diabetes and advanced chronic kidney disease. The experts addressed the best techniques for treating patients with diabetes before transplant, managing kidney disease in patients with diabetes, treating diabetes after transplantation, and improving long-term kidney transplant outcomes in patients with diabetes.

The work groups found that an increasing number of people appear to be developing diabetes for the first time after kidney transplant. As a result, they suffer as many adverse ill effects during an eight-to-10-year period as people who had preexisting diabetes, largely because of their increased risk of cardiovascular disease. Experts noted that some people diagnosed with posttransplant diabetes mellitus likely had undetected signs of the condition before the transplant.

The same factors that put people at risk for diabetes before transplant likely increased the risk of diabetes after transplant, the experts noted. These risk factors include a family history of the disease, increased age, and obesity. Additionally, some of the medications that help prevent the body from rejecting the new organ have been linked to an increased risk of posttransplant diabetes mellitus.

To prevent diabetes and manage pre-existing diabetes in kidney transplant patients, the experts recommend that physicians try to modify transplant medications without increasing the risk of rejection and encourage patients to adopt the same techniques that help prevent and manage diabetes in the general population, including losing weight, exercising, and taking medications to reduce blood pressure and cholesterol.

Diabetes After Kidney Transplant on the Rise (news release, New York: National Kidney Foundation, Sept 2, 2004) http:// www.kidney.org/general/news/newsitem .cfm?id=229 (accessed 9 Sept 2004).

Copyright Association of Operating Room Nurses, Inc. Nov 2004