Lower magnesium level associated with new-onset diabetes and pre-diabetes after kidney transplantation
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Hypomagnesemia is associated with increased peripheral insulin resistance in the general population. It is frequently seen after renal transplantation. We examined its role as a risk factor for new-onset diabetes after transplantation (NODAT) and new-onset pre-diabetes after transplantation (NOPDAT).
A retrospective analysis of 138 previously non-diabetic renal transplant recipients was conducted. Cox and logistic regression analyses were performed to examine the associations between 1-month post-transplant serum magnesium level and subsequent diagnoses of NODAT/NOPDAT.
NODAT was diagnosed in 34 (24.6 %) and NOPDAT in 12 (8.7 %) patients. Median time to diagnosis of NODAT/NOPDAT was 20.4 months (interquartile range [IQR] 6.8–34.8). Median follow up for the entire group was 3.5 years (IQR 2.3–5.6). Mean magnesium level at 1 month after transplantation was significantly lower in patients subsequently diagnosed with NODAT/NOPDAT (1.60 ± 0.27 vs. 1.76 ± 0.29 mg/dl, p = 0.002). Cox regression analysis identified a trend towards developing NODAT/NOPDAT with lower baseline magnesium levels (hazard ratio 0.89 per 0.1 mg/dl increment in magnesium level, 95 % confidence interval [CI] = 0.78–1.01, p = 0.07); a stronger relationship between the two variables was seen at logistic regression analysis (odds ratio 0.81 per 0.1 mg/dl increment in serum magnesium (95 % CI 0.67–0.98, p = 0.03).
A lower magnesium level at 1 month after transplantation may be predictive of a subsequent diagnosis of glucose intolerance or diabetes in renal transplant recipients. Whether replenishing magnesium stores can prevent development of these disorders requires further investigation.
KeywordsMagnesium Calcineurin inhibitors New onset diabetes mellitus New onset pre-diabetes Renal transplantation
Conflict of interest
On behalf of all the authors, the corresponding author states there is no conflict of interest.
- 6.Davidson J, Wilkinson A, Dantal J, et al (2003) New-onset diabetes after transplantation: 2003 International consensus guidelines. Proceedings of an international expert panel meeting. Barcelona, Spain, 19 February 2003. Transplantation 75(10 Suppl):SS3–S24Google Scholar
- 18.Tillmann FP, Quack I, Schenk A, Grabensee B, Rump LC, Hetzel GR (2012) Prevalence and risk factors of pre-diabetes after renal transplantation: a single-centre cohort study in 200 consecutive patients. Nephrol Dial Transpl 27(8):3330–3337Google Scholar
- 38.American Diabetes A (2012) Diagnosis and classification of diabetes mellitus. Diabetes Care 35 Suppl 1:S64–S71Google Scholar