Side effects of the calcineurin inhibitor, such as new-onset diabetes after kidney transplantation

Borda, Bernadett and Lengyel, Cs. and Várkonyi, T. and Kemény, É. and Ottlakán, A. and Kubik, A. and Keresztes, Cs. and Lázár, Gy. (2014) Side effects of the calcineurin inhibitor, such as new-onset diabetes after kidney transplantation. Acta Physiologica Hungarica, 101 (3). pp. 388-394. ISSN 0231-424X

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Abstract

New-onset diabetes after transplantation (NODAT) is one of the frequent complications following kidney transplantation. Patients were randomized to receive cyclosporine A- or tacrolimus-based immunosuppression. Fasting and oral glucose tolerance tests were performed, and the patients were assigned to one of the following three groups based on the results: normal, impaired fasting glucose/impaired glucose tolerance (IFG/IGT), or NODAT. NODAT developed in 14% of patients receiving cyclosporine A-based immunosuppression and in 26% of patients taking tacrolimus (p = 0.0002). Albumin levels were similar, but uric acid level (p = 0.002) and the age of the recipient (p = 0.003) were significantly different comparing the diabetic and the normal groups. Evaluation of tissue samples revealed that acute cellular rejection (ACR) and interstitial fibrosis/tubular atrophy (IF/TA) were significantly different in the NODAT group. The pathological effect of new-onset diabetes after kidney transplantation can be detected in the morphology of the renal allograft earlier, before the development of any sign of functional impairment.

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