Skip to main content

Advertisement

SpringerLink
Log in

Prevalence of new-onset diabetes mellitus after kidney transplantation: a systematic review and meta-analysis

  • Review Article
  • Published:
Acta Diabetologica Aims and scope Submit manuscript

Abstract

Aims

Post-transplant diabetes is a prevalent and consequential complication following kidney transplantation, which significantly augments the risk of cardiovascular disease, graft loss, infection, and mortality, thereby profoundly impacting both graft and patient survival. However, the early stages of post-transplant diabetes often go unnoticed or receive inadequate management. Consequently, this study systematically assesses the incidence of new-onset diabetes after kidney transplantation with the aim to enhance medical staff awareness regarding post-transplantation diabetes and provide clinical management guidance.

Methods

We conducted a comprehensive search across multiple databases including PubMed, Web of Science, Embase, The Cochrane Library, CNKI, Wanfang, VIP, and SinoMed until September 21, 2023. Data extraction was performed using standardized tables and meta-analysis was conducted using Stata 16.0 software. A random effects model was employed to estimate the combined prevalence along with its corresponding 95% confidence interval. The source of heterogeneity was explored using subgroup analysis and sensitivity analysis, while publication bias was assessed through funnel plot and Egger's test. This study has been registered with PROSPERO under the registration number CRD42023465768.

Results

This meta-analysis comprised 39 studies with a total sample size of 16,584 patients. The prevalence of new-onset diabetes after transplantation was found to be 20% [95% CI (18.0, 22.0)]. Subgroup analyses were conducted based on age, gender, body mass index, family history of diabetes, type of kidney donor, immunosuppressive regimen, acute rejection episodes, hepatitis C infection status and cytomegalovirus infection.

Conclusions

The incidence of post-kidney transplantation diabetes is substantial, necessitating early implementation of preventive and control measures to mitigate its occurrence, enhance prognosis, and optimize patients' quality of life.

Clinical trial registration: PROSPERO: CRD42023465768.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Klangjareonchai T, Eguchi N, Tantisattamo E et al (2021) Current pharmacological intervention and medical management for diabetic kidney transplant recipients. Pharmaceutics. https://doi.org/10.3390/pharmaceutics13030413

    Article  PubMed  PubMed Central  Google Scholar 

  2. Montada-Atin T, Prasad GVR (2021) Recent advances in new-onset diabetes mellitus after kidney transplantation. World J Diabetes 12:541–555. https://doi.org/10.4239/wjd.v12.i5.541

    Article  PubMed  PubMed Central  Google Scholar 

  3. Alkadi MM, Abuhelaiqa E, Jerobin J et al (2020) Prediabetes and older age increase the risk of post-transplantation diabetes mellitus: Qatar experience. Clin Transpl 34:e13892. https://doi.org/10.1111/ctr.13892

    Article  Google Scholar 

  4. Martinez Cantarin MP (2021) Diabetes in kidney transplantation. Adv Chron Kidney Dis 28:596–605. https://doi.org/10.1053/j.ackd.2021.10.004

    Article  Google Scholar 

  5. Ong SC, Rhee CM (2021) Novel management of diabetes in kidney transplantation. Curr Opin Nephrol Hypertens 30:5–13. https://doi.org/10.1097/mnh.0000000000000665

    Article  CAS  PubMed  Google Scholar 

  6. Martin-Moreno PL, Shin HS, Chandraker A (2021) Obesity and post-transplant diabetes mellitus in kidney transplantation. J Clin Med. https://doi.org/10.3390/jcm10112497

    Article  PubMed  PubMed Central  Google Scholar 

  7. Zhang Z, Sun J, Guo M et al (2023) Progress of new-onset diabetes after liver and kidney transplantation. Front Endocrinol (Lausanne) 14:1091843. https://doi.org/10.3389/fendo.2023.1091843

    Article  PubMed  Google Scholar 

  8. Heldal TF, Ueland T, Jenssen T et al (2018) Inflammatory and related biomarkers are associated with post-transplant diabetes mellitus in kidney recipients: a retrospective study. Transpl Int 31:510–519. https://doi.org/10.1111/tri.13116

    Article  CAS  PubMed  Google Scholar 

  9. Hagen M, Hjelmesaeth J, Jenssen T et al (2003) A 6-year prospective study on new onset diabetes mellitus, insulin release and insulin sensitivity in renal transplant recipients. Nephrol Dial Transpl 18:2154–2159. https://doi.org/10.1093/ndt/gfg338

    Article  CAS  Google Scholar 

  10. Werzowa J, Säemann M, Haidinger M et al (2015) Antidiabetic therapy in post kidney transplantation diabetes mellitus. Transpl Rev (Orlando) 29:145–153. https://doi.org/10.1016/j.trre.2015.01.001

    Article  Google Scholar 

  11. Dos Santos Q, Hornum M, Terrones-Campos C et al (2022) Posttransplantation diabetes mellitus among solid organ recipients in a Danish cohort. Transpl Int 35:10352. https://doi.org/10.3389/ti.2022.10352

    Article  PubMed  PubMed Central  Google Scholar 

  12. Kang E, Lee J, Kang DH et al (2022) Clinical outcomes of posttransplantation diabetes mellitus in kidney transplantation recipients: a nationwide population-based cohort study in Korea. Sci Rep 12:21632. https://doi.org/10.1038/s41598-022-25070-z

    Article  ADS  CAS  PubMed  PubMed Central  Google Scholar 

  13. Wang L, Huang J, Li Y et al (2023) Postoperative fasting plasma glucose and family history diabetes mellitus can predict post-transplantation diabetes mellitus in kidney transplant recipients. Endocrine 81:58–66. https://doi.org/10.1007/s12020-023-03374-y

    Article  CAS  PubMed  Google Scholar 

  14. Lin H, Yan J, Yuan L et al (2021) Impact of diabetes mellitus developing after kidney transplantation on patient mortality and graft survival: a meta-analysis of adjusted data. Diabetol Metab Syndr 13:126. https://doi.org/10.1186/s13098-021-00742-4

    Article  PubMed  PubMed Central  Google Scholar 

  15. Chevallier E, Jouve T, Rostaing L et al (2021) pre-existing diabetes and PTDM in kidney transplant recipients: how to handle immunosuppression. Expert Rev Clin Pharmacol 14:55–66. https://doi.org/10.1080/17512433.2021.1851596

    Article  CAS  PubMed  Google Scholar 

  16. Yeh H, Lin C, Li YR et al (2020) Temporal trends of incident diabetes mellitus and subsequent outcomes in patients receiving kidney transplantation: a national cohort study in Taiwan. Diabetol Metab Syndr 12:34. https://doi.org/10.1186/s13098-020-00541-3

    Article  PubMed  PubMed Central  Google Scholar 

  17. Dienemann T, Fujii N, Li Y et al (2016) Long-term patient survival and kidney allograft survival in post-transplant diabetes mellitus: a single-center retrospective study. Transpl Int 29:1017–1028. https://doi.org/10.1111/tri.12807

    Article  CAS  PubMed  Google Scholar 

  18. Boudreaux JP, Mchugh L, Canafax DM et al (1987) The impact of cyclosporine and combination immunosuppression on the incidence of posttransplant diabetes in renal allograft recipients. Transplantation 44:376–381. https://doi.org/10.1097/00007890-198709000-00010

    Article  CAS  PubMed  Google Scholar 

  19. Zeng XT, Liu H, Chen X et al (2012) Meta-analysis Series IV: Quality assessment tools for observational studies. Chinese Journal of Evidence-based Cardiovascular Medicine 4:297–299. https://doi.org/10.3969/j.1674-4055.2012.04.004

    Article  ADS  Google Scholar 

  20. Rotenstein LS, Ramos MA, Torre M et al (2016) Prevalence of depression, depressive symptoms, and suicidal ideation among medical students: a systematic review and meta-analysis. JAMA 316:2214–2236. https://doi.org/10.1001/jama.2016.17324

    Article  PubMed  PubMed Central  Google Scholar 

  21. Huedo-Medina TB, Sánchez-Meca J, Marín-Martínez F et al (2006) Assessing heterogeneity in meta-analysis: Q statistic or I2 index? Psychol Methods 11:193–206. https://doi.org/10.1037/1082-989x.11.2.193

    Article  PubMed  Google Scholar 

  22. Jeon JY, Han-Bit S, Park BH et al (2023) Impact of Post-Transplant Diabetes Mellitus on Survival and Cardiovascular Events in Kidney Transplant Recipients. Endocrinol Metab (Seoul) 38:139–145. https://doi.org/10.3803/EnM.2022.1594

    Article  CAS  PubMed  Google Scholar 

  23. Luo DK (2022) Single-center analysis of risk factors for diabetes mellitus after kidney transplantation in adults. In: Hainan Medical University. https://doi.org/10.27952/d.cnki.ghnyx.2022.000033

  24. Ye Y, Gao J, Liang J et al (2021) Association between preoperative lipid profiles and new-onset diabetes after transplantation in Chinese kidney transplant recipients: a retrospective cohort study. J Clin Lab Anal 35:e23867. https://doi.org/10.1002/jcla.23867

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Pham VuT, Nguyen Thi Thuy D, Truong Quy K et al (2021) Serum hs-CRP measured prior transplantation predicts of new-onset diabetes after transplantation in renal transplant recipients. Transpl Immunol 66:101392. https://doi.org/10.1016/j.trim.2021.101392

    Article  CAS  Google Scholar 

  26. Helvaci Ö, Korucu B, Yeter HH et al (2021) TCF7L2 (rs7903146) but not CDKAL1 (rs7754840) gene polymorphisms increase the risk of new-onset diabetes after kidney transplant. Exp Clin Transpl. https://doi.org/10.6002/ect.2020.0335

    Article  Google Scholar 

  27. Kirnap NG, Bozkus Y, Haberal M (2020) Analysis of risk factors for posttransplant diabetes mellitus after kidney transplantation: single-center experience. Exp Clin Transpl 18:36–40. https://doi.org/10.6002/ect.TOND-TDTD2019.O8

    Article  Google Scholar 

  28. Cheng CY, Feng YT, Wang HY (2020) Incidence and relative risk factors in posttransplant diabetes mellitus patients: a retrospective cohort study. Korean J Transpl 34:213–237. https://doi.org/10.4285/kjt.20.0026

    Article  Google Scholar 

  29. Bang JB, Oh CK, Kim YS et al (2020) Insulin secretion and insulin resistance trajectories over 1 year after kidney transplantation: a multicenter prospective cohort study. Endocrinol Metab (Seoul) 35:820–829. https://doi.org/10.3803/EnM.2020.743

    Article  CAS  PubMed  Google Scholar 

  30. Ajabnoor A, Nasser M, Khan N et al (2020) Evaluation of tacrolimus trough level in patients who developed post-transplant diabetes mellitus after kidney transplantation: a retrospective single-center study in Saudi Arabia. Transplant Proc 52:3160–3167. https://doi.org/10.1016/j.transproceed.2020.05.014

    Article  CAS  PubMed  Google Scholar 

  31. Dong F (2020) Analysis of influencing factors and islet function of blood glucose in patients with abnormal glucose metabolism after kidney transplantation. In: Qingdao University. https://doi.org/10.27262/d.cnki.gqdau.2020.000434

  32. Londero TM, Giaretta LS, Farenzena LP et al (2019) Microvascular complications of posttransplant diabetes mellitus in kidney transplant recipients: a longitudinal study. J Clin Endocrinol Metab 104:557–567. https://doi.org/10.1210/jc.2018-01521

    Article  PubMed  Google Scholar 

  33. Lai XQ, Zhang L, Fang JL et al (2019) OGTT 2-hour serum C-peptide index as a predictor of post-transplant diabetes mellitus in kidney transplant recipients. Ann Transl Medi. https://doi.org/10.21037/atm.2019.10.14

    Article  Google Scholar 

  34. Choudhury P, Mukhopadhyay P, Roychowdhary A et al (2019) Prevalence and predictors of “New-onset diabetes after transplantation” (NODAT) in renal transplant recipients: an observational study. Indian J Endocrinol Metab 23:273–277. https://doi.org/10.4103/ijem.IJEM-178-19

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Biró B, Szabó RP, Illésy L et al (2019) Regulatory T cells in the context of new-onset diabetes after renal transplant: a single-center experience. Transpl Proc 51:1234–1238. https://doi.org/10.1016/j.transproceed.2019.03.007

    Article  Google Scholar 

  36. Lai XQ, Zhang L, Fang JL et al (2019) Analysis of risk factors for post-transplant diabetes mellitus in patients with renal transplants. Chin J Endocr Surg 13:450–455. https://doi.org/10.3760/cma.j.issn.1674-6090.2019.06.003

    Article  Google Scholar 

  37. Xue M, Zhao C, Lv C et al (2018) Interleukin-2 receptor antagonists: Protective factors against new-onset diabetes after renal transplantation. J Diabetes 10:857–865. https://doi.org/10.1111/1753-0407.12663

    Article  CAS  PubMed  Google Scholar 

  38. Xu J, Xu L, Wei X et al (2018) Incidence and risk factors of posttransplantation diabetes mellitus in living donor kidney transplantation: a single-center retrospective study in China. Transpl Proc 50:3381–3385. https://doi.org/10.1016/j.transproceed.2018.08.007

    Article  CAS  Google Scholar 

  39. Gomes V, Ferreira F, Guerra J et al (2018) New-onset diabetes after kidney transplantation: incidence and associated factors. World J Diabetes 9:132–137. https://doi.org/10.4239/wjd.v9.i7.132

    Article  PubMed  PubMed Central  Google Scholar 

  40. Meng PP (2018) Risk factors and pathogenesis of new-onset diabetes after kidney transplantation. In: Qingdao University. CNKI:CDMD:2.1018.880663

  41. Ahmed I, Osman RKH, Khalifa NO et al (2017) New-onset diabetes after transplant in a Sudanese renal transplant population: prevalence and risk factors. Exp Clin Transpl 15:627–630. https://doi.org/10.6002/ect.2016.0198

    Article  Google Scholar 

  42. Yang J, Fang F, Yang F (2017) Risk factors of new-onset diabetes mellitus after kidney transplantation: a retrospective study. Chin J Tissue Eng Res 21:3275–3280. https://doi.org/10.3969/j.issn.2095-4344.2017.20.025

    Article  Google Scholar 

  43. Porrini EL, Díaz JM, Moreso F et al (2016) Clinical evolution of post-transplant diabetes mellitus. Nephrol Dial Transpl 31:495–505. https://doi.org/10.1093/ndt/gfv368

    Article  CAS  Google Scholar 

  44. Aleid H, Alhuraiji A, Alqaraawi A et al (2016) New-onset diabetes after kidney transplantation: Incidence, risk factors, and outcomes. Saudi J Kidney Dis Transpl 27:1155–1161. https://doi.org/10.4103/1319-2442.194603

    Article  PubMed  Google Scholar 

  45. Li N (2016) Status of diabetes mellitus and its relationship with anxiety and depression in patients with renal transplantation. In: Shandong University. https://doi.org/10.7666/d.Y3036078

  46. Wang YJ, Di WJ, Sun Q et al (2015) Post-transplantation diabetes mellitus and the risk factors. Chin J Nephrol Dial Transpl 24:21–25

    Google Scholar 

  47. Yao B, Chen X, Shen FX et al (2013) The incidence of posttransplantation diabetes mellitus during follow-up in kidney transplant recipients and relationship to Fok1 vitamin D receptor polymorphism. Transpl Proc 45:194–196. https://doi.org/10.1016/j.transproceed.2012.08.019

    Article  CAS  Google Scholar 

  48. Borda B, Lengyel C, Szederkényi E et al (2012) Post-transplant diabetes mellitus—risk factors and effects on the function and morphology of the allograft. Acta Physiol Hung 99:206–215. https://doi.org/10.1556/APhysiol.99.2012.2.14

    Article  CAS  PubMed  Google Scholar 

  49. He CY, Bi HM (2012) Clinical features and risk factors of diabetes mellitus after kidney transplantation. Pract Geriatr 26:50–52. https://doi.org/10.3969/j.issn.1003-9198.2012.01.014

    Article  CAS  Google Scholar 

  50. Xu Y, Liang JX, Liu B et al (2011) Prevalence and long-term glucose metabolism evolution of post-transplant diabetes mellitus in Chinese renal recipients. Diabetes Res Clin Pract 92:11–18. https://doi.org/10.1016/j.diabres.2010.12.006

    Article  CAS  PubMed  Google Scholar 

  51. Ergün I, Keven K, Sengül S et al (2011) Endothelial nitric oxide synthase gene intron 4 polymorphism predicts new onset diabetes mellitus after transplantation in kidney allograft recipients treated with cyclosporin A. Int Urol Nephrol 43:543–548. https://doi.org/10.1007/s11255-010-9786-8

    Article  CAS  PubMed  Google Scholar 

  52. Borda B, Szederkényi E, Lengyel C et al (2011) Functional and histopathologic changes in renal transplant patients with new-onset diabetes and dyslipidemia. Transpl Proc 43:1254–1258. https://doi.org/10.1016/j.transproceed.2011.03.091

    Article  CAS  Google Scholar 

  53. Li J, Liu JD, Li W (2011) Risk factors for new-onset diabetes after kidney transplantation. China Modern Doctor 49:18–19. https://doi.org/10.3969/j.issn.1673-9701.2011.14.008

    Article  ADS  Google Scholar 

  54. Marrero D, Hernandez D, Tamajón LP et al (2010) Pre-transplant weight but not weight gain is associated with new-onset diabetes after transplantation: a multi-centre cohort Spanish study. NDT Plus 3:ii15–ii20. https://doi.org/10.1093/ndtplus/sfq065

    Article  PubMed  PubMed Central  Google Scholar 

  55. Gnatta D, Keitel E, Heineck I et al (2010) Use of tacrolimus and the development of posttransplant diabetes mellitus: a Brazilian single-center, observational study. Transpl Proc 42:475–478. https://doi.org/10.1016/j.transproceed.2010.02.021

    Article  CAS  Google Scholar 

  56. Mollar-Puchades MA, Malek-Marin T, Merino-Torres JF et al (2009) Diabetes mellitus after kidney transplantation: role of the impaired fasting glucose in the outcome of kidney transplantation. J Endocrinol Invest 32:263–266. https://doi.org/10.1007/bf03346464

    Article  CAS  PubMed  Google Scholar 

  57. Chen X, Yao B, Dong TT et al (2009) The characteristics and risk factors for post-transplantation diabetes mellitus. Zhonghua Nei Ke Za Zhi 48:547–551

    PubMed  Google Scholar 

  58. Mazali FC, Lalli CA, Alves-Filho G et al (2008) Posttransplant diabetes mellitus: incidence and risk factors. Transpl Proc 40:764–766. https://doi.org/10.1016/j.transproceed.2008.03.018

    Article  Google Scholar 

  59. Liu HT, Peng LK, Xie XB et al (2006) Clinic analysis of post-transplant diabete mellitus in kidney transplant recipients. Chin J Mod Oper Surg 10:215–217. https://doi.org/10.3969/j.issn.1009-2188.2006.03.018

    Article  CAS  Google Scholar 

  60. Cho YM, Park KS, Jung HS et al (2003) High incidence of tacrolimus-associated posttransplantation diabetes in the Korean renal allograft recipients according to American Diabetes Association criteria. Diabetes Care 26:1123–1128. https://doi.org/10.2337/diacare.26.4.1123

    Article  CAS  PubMed  Google Scholar 

  61. Cerf ME (2013) Beta cell dysfunction and insulin resistance. Front Endocrinol (Lausanne) 4:37. https://doi.org/10.3389/fendo.2013.00037

    Article  PubMed  Google Scholar 

  62. Jenssen T, Hartmann A (2019) Post-transplant diabetes mellitus in patients with solid organ transplants. Nat Rev Endocrinol 15:172–188. https://doi.org/10.1038/s41574-018-0137-7

    Article  PubMed  Google Scholar 

  63. Rysz J, Franczyk B, Radek M et al. (2021) Diabetes and Cardiovascular Risk in Renal Transplant Patients. Int J Mol Sci 22. https://doi.org/10.3390/ijms22073422

  64. Ohn JH, Kwak SH, Cho YM et al (2016) 10-year trajectory of β-cell function and insulin sensitivity in the development of type 2 diabetes: a community-based prospective cohort study. Lancet Diabetes Endocrinol 4:27–34. https://doi.org/10.1016/s2213-8587(15)00336-8

    Article  CAS  PubMed  Google Scholar 

  65. Pham PT, Pham PM, Pham SV et al (2011) New onset diabetes after transplantation (NODAT): an overview. Diabetes Metab Syndr Obes 4:175–186. https://doi.org/10.2147/dmso.S19027

    Article  PubMed  PubMed Central  Google Scholar 

  66. Rodríguez-Rodríguez AE, Porrini E, Hornum M et al (2021) Post-transplant diabetes mellitus and prediabetes in renal transplant recipients: an update. Nephron 145:317–329. https://doi.org/10.1159/000514288

    Article  CAS  PubMed  Google Scholar 

  67. Davidson J, Wilkinson A, Dantal J et al. (2003) New-onset diabetes after transplantation: 2003 international consensus guidelines. In: Proceedings of an international expert panel meeting. Barcelona, Spain, 19 February 2003. Transplantation 75:Ss3–24. https://doi.org/10.1097/01.Tp.0000069952.49242.3e

  68. Conte C, Secchi A (2018) Post-transplantation diabetes in kidney transplant recipients: an update on management and prevention. Acta Diabetol 55:763–779. https://doi.org/10.1007/s00592-018-1137-8

    Article  PubMed  Google Scholar 

  69. Sharif A, Moore R, Baboolal K (2008) Influence of lifestyle modification in renal transplant recipients with postprandial hyperglycemia. Transplantation 85:353–358. https://doi.org/10.1097/TP.0b013e3181605ebf

    Article  PubMed  Google Scholar 

  70. Chowdhury TA (2019) Post-transplant diabetes mellitus. Clin Med (Lond) 19:392–395. https://doi.org/10.7861/clinmed.2019-0195

    Article  PubMed  PubMed Central  Google Scholar 

  71. Maskey R (2014) New-onset diabetes after transplant (NODAT). Kathmandu Univ Med J (KUMJ) 12:301–305. https://doi.org/10.3126/kumj.v12i4.13740

    Article  CAS  PubMed  Google Scholar 

  72. Palepu S, Prasad GV (2015) New-onset diabetes mellitus after kidney transplantation: current status and future directions. World J Diabetes 6:445–455. https://doi.org/10.4239/wjd.v6.i3.445

    Article  PubMed  PubMed Central  Google Scholar 

  73. Razeghi E, Heydarian P, Amerian M et al (2010) The risk factors for diabetes mellitus after kidney transplantation. Saudi J Kidney Dis Transpl 21:1038–1043

    PubMed  Google Scholar 

  74. Cheng F, Li Q, Wang J et al (2022) Analysis of risk factors and establishment of a risk prediction model for post-transplant diabetes mellitus after kidney transplantation. Saudi Pharm J 30:1088–1094. https://doi.org/10.1016/j.jsps.2022.05.013

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  75. Anonymous (2014) Standards of medical care in diabetes–2014. Diabetes Care 37(Suppl 1):S14-80. https://doi.org/10.2337/dc14-S014

    Article  Google Scholar 

  76. Gulsoy Kirnap N, Bozkus Y, Haberal M (2020) Analysis of risk factors for posttransplant diabetes mellitus after kidney transplantation: single-center experience. Exp Clin Transpl 18:36–40. https://doi.org/10.6002/ect.TOND-TDTD2019.O8

    Article  Google Scholar 

  77. Gourishankar S, Jhangri GS, Tonelli M et al (2004) Development of diabetes mellitus following kidney transplantation: a Canadian experience. Am J Transpl 4:1876–1882. https://doi.org/10.1111/j.1600-6143.2004.00591.x

    Article  Google Scholar 

  78. Aregbesola A, Voutilainen S, Virtanen JK et al (2017) Gender difference in type 2 diabetes and the role of body iron stores. Ann Clin Biochem 54:113–120. https://doi.org/10.1177/0004563216646397

    Article  CAS  PubMed  Google Scholar 

  79. Issaka A, Cameron AJ, Paradies Y et al (2022) Effect of age and sex on the associations between potential modifiable risk factors and both type 2 diabetes and impaired fasting glycaemia among West African adults. BMC Public Health 22:1211. https://doi.org/10.1186/s12889-022-13588-w

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  80. Yeap BB, Wittert GA (2022) Testosterone, diabetes risk, and diabetes prevention in men. Endocrinol Metab Clin North Am 51:157–172. https://doi.org/10.1016/j.ecl.2021.11.004

    Article  PubMed  Google Scholar 

  81. Ahern T, Wu FC (2015) New horizons in testosterone and the ageing male. Age Ageing 44:188–195. https://doi.org/10.1093/ageing/afv007

    Article  PubMed  Google Scholar 

  82. Keating NL, O’malley AJ, Smith MR (2006) Diabetes and cardiovascular disease during androgen deprivation therapy for prostate cancer. J Clin Oncol 24:4448–4456. https://doi.org/10.1200/JCO.2006.06.2497

    Article  CAS  PubMed  Google Scholar 

  83. Kooptiwut S, Hanchang W, Semprasert N et al (2015) Testosterone reduces AGTR1 expression to prevent β-cell and islet apoptosis from glucotoxicity. J Endocrinol 224:215–224. https://doi.org/10.1530/JOE-14-0397

    Article  CAS  PubMed  Google Scholar 

  84. Stam SP, Sokooti S, Eisenga MF et al (2021) Androgens and development of posttransplantation diabetes mellitus in male kidney transplant recipients: a post hoc analysis of a prospective study. Diabetes Care 44:2683–2690. https://doi.org/10.2337/dc21-0237

    Article  CAS  PubMed  Google Scholar 

  85. Navarro G, Xu W, Jacobson DA et al (2016) Extranuclear actions of the androgen receptor enhance glucose-stimulated insulin secretion in the male. Cell Metab 23:837–851. https://doi.org/10.1016/j.cmet.2016.03.015

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  86. Lofaro D, Perri A, Aversa A et al (2018) Testosterone in renal transplant patients: effect on body composition and clinical parameters. J Nephrol 31:775–783. https://doi.org/10.1007/s40620-018-0513-3

    Article  CAS  PubMed  Google Scholar 

  87. Dedinská I, Graňák K, Vnučák M et al (2019) Role of sex in post-transplant diabetes mellitus development: Are men and women equal? J Diabetes Complicat 33:315–322. https://doi.org/10.1016/j.jdiacomp.2018.12.017

    Article  Google Scholar 

  88. Ibe A, Smith TC (2014) Diabetes in US women on the rise independent of increasing BMI and other risk factors; a trend investigation of serial cross-sections. BMC Public Health 14:954. https://doi.org/10.1186/1471-2458-14-954

    Article  PubMed  PubMed Central  Google Scholar 

  89. Nagaya T, Yoshida H, Takahashi H et al (2005) Increases in body mass index, even within non-obese levels, raise the risk for Type 2 diabetes mellitus: a follow-up study in a Japanese population. Diabet Med 22:1107–1111. https://doi.org/10.1111/j.1464-5491.2005.01602.x

    Article  CAS  PubMed  Google Scholar 

  90. Conte C, Maggiore U, Cappelli G et al (2020) Management of metabolic alterations in adult kidney transplant recipients: A joint position statement of the Italian Society of Nephrology (SIN), the Italian Society for Organ Transplantation (SITO) and the Italian Diabetes Society (SID). Nutr Metab Cardiovasc Dis 30:1427–1441. https://doi.org/10.1016/j.numecd.2020.05.004

    Article  PubMed  Google Scholar 

  91. Chan W, Bosch JA, Jones D et al (2014) Obesity in kidney transplantation. J Ren Nutr 24:1–12. https://doi.org/10.1053/j.jrn.2013.09.002

    Article  PubMed  Google Scholar 

  92. Han E, Kim MS, Kim YS et al (2016) Risk assessment and management of post-transplant diabetes mellitus. Metabolism 65:1559–1569. https://doi.org/10.1016/j.metabol.2016.07.011

    Article  CAS  PubMed  Google Scholar 

  93. Stinkens R, Goossens GH, Jocken JW et al (2015) Targeting fatty acid metabolism to improve glucose metabolism. Obes Rev 16:715–757. https://doi.org/10.1111/obr.12298

    Article  CAS  PubMed  Google Scholar 

  94. Kwan JM, Hajjiri Z, Metwally A et al (2016) Effect of the obesity epidemic on kidney transplantation: obesity is independent of diabetes as a risk factor for adverse renal transplant outcomes. PLoS ONE 11:e0165712. https://doi.org/10.1371/journal.pone.0165712

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  95. Hoogeveen EK, Aalten J, Rothman KJ et al (2011) Effect of obesity on the outcome of kidney transplantation: a 20-year follow-up. Transplantation 91:869–874. https://doi.org/10.1097/TP.0b013e3182100f3a

    Article  PubMed  Google Scholar 

  96. Evert AB, Dennison M, Gardner CD et al (2019) Nutrition therapy for adults with diabetes or prediabetes: a consensus report. Diabetes Care 42:731–754. https://doi.org/10.2337/dci19-0014

    Article  PubMed  PubMed Central  Google Scholar 

  97. Knowler WC, Barrett-Connor E, Fowler SE et al (2002) Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 346:393–403. https://doi.org/10.1056/NEJMoa012512

    Article  CAS  PubMed  Google Scholar 

  98. Courivaud C, Ladrière M, Toupance O et al (2011) Impact of pre-transplant dialysis modality on post-transplant diabetes mellitus after kidney transplantation. Clin Transpl 25:794–799. https://doi.org/10.1111/j.1399-0012.2010.01367.x

    Article  Google Scholar 

  99. Cosentino F, Grant PJ, Aboyans V et al (2020) 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD. Eur Heart J 41:255–323. https://doi.org/10.1093/eurheartj/ehz486

    Article  PubMed  Google Scholar 

  100. Zamora-Ginez I, Pérez-Fuentes R, Baez-Duarte BG et al (2012) Risk factors for diabetes, but not for cardiovascular disease, are associated with family history of Type 2 diabetes in subjects from central Mexico. Ann Hum Biol 39:102–107. https://doi.org/10.3109/03014460.2011.645507

    Article  PubMed  Google Scholar 

  101. Ertuglu LA, Porrini E, Hornum M et al (2021) Glucagon-like peptide-1 receptor agonists and sodium-glucose cotransporter 2 inhibitors for diabetes after solid organ transplantation. Transpl Int 34:1341–1359. https://doi.org/10.1111/tri.13883

    Article  CAS  PubMed  Google Scholar 

  102. Lv C, Chen M, Xu M et al (2014) Influencing factors of new-onset diabetes after a renal transplant and their effects on complications and survival rate. PLoS ONE 9:e99406. https://doi.org/10.1371/journal.pone.0099406

    Article  ADS  CAS  PubMed  PubMed Central  Google Scholar 

  103. Lancia P, Adam De Beaumais T, Elie V et al (2018) Pharmacogenetics of post-transplant diabetes mellitus in children with renal transplantation treated with tacrolimus. Pediatr Nephrol 33:1045–1055. https://doi.org/10.1007/s00467-017-3881-3

    Article  PubMed  Google Scholar 

  104. Shivaswamy V, Boerner B, Larsen J (2016) Post-transplant diabetes mellitus: causes, treatment, and impact on outcomes. Endocr Rev 37:37–61. https://doi.org/10.1210/er.2015-1084

    Article  CAS  PubMed  Google Scholar 

  105. Cheungpasitporn W, Thongprayoon C, Harindhanavudhi T et al (2016) Hypomagnesemia linked to new-onset diabetes mellitus after kidney transplantation: a systematic review and meta-analysis. Endocr Res 41:142–147. https://doi.org/10.3109/07435800.2015.1094088

    Article  CAS  PubMed  Google Scholar 

  106. Garnier AS, Duveau A, Planchais M et al (2018) Serum magnesium after kidney transplantation: a systematic review. Nutrients. https://doi.org/10.3390/nu10060729

    Article  PubMed  PubMed Central  Google Scholar 

  107. Yu H, Kim H, Baek CH et al (2016) Risk factors for new-onset diabetes mellitus after living donor kidney transplantation in Korea - a retrospective single center study. BMC Nephrol 17:106. https://doi.org/10.1186/s12882-016-0321-8

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  108. Muduma G, Saunders R, Odeyemi I et al (2016) Systematic review and meta-analysis of tacrolimus versus ciclosporin as primary immunosuppression after liver transplant. PLoS ONE 11:e0160421. https://doi.org/10.1371/journal.pone.0160421

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  109. Baron PW, Infante S, Peters R et al (2017) Post-transplant diabetes mellitus after kidney transplant in hispanics and caucasians treated with tacrolimus-based immunosuppression. Ann Transpl 22:309–314. https://doi.org/10.12659/aot.903079

    Article  CAS  Google Scholar 

  110. Jehn U, Wiedmer N, Boeckel GR et al (2022) Fast tacrolimus metabolism does not promote post-transplant diabetes mellitus after kidney transplantation. Int J Mol Sci. https://doi.org/10.3390/ijms23169131

    Article  PubMed  PubMed Central  Google Scholar 

  111. Alghanem SS, Soliman MM, Alibrahim AA et al (2020) Monitoring tacrolimus trough concentrations during the first year after kidney transplantation: a national retrospective cohort study. Front Pharmacol 11:566638. https://doi.org/10.3389/fphar.2020.566638

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  112. Andrade-Sierra J, Contreras AM, Monteon FJ et al (2006) Risk factors and incidence of posttransplant diabetes mellitus in Mexican kidney recipients. Arch Med Res 37:961–966. https://doi.org/10.1016/j.arcmed.2006.05.004

    Article  PubMed  Google Scholar 

  113. Ahmed SH, Biddle K, Augustine T et al (2020) Post-transplantation diabetes mellitus. Diabetes Ther 11:779–801. https://doi.org/10.1007/s13300-020-00790-5

    Article  PubMed  PubMed Central  Google Scholar 

  114. Fabrizi F, Martin P, Dixit V et al (2005) Post-transplant diabetes mellitus and HCV seropositive status after renal transplantation: meta-analysis of clinical studies. Am J Transpl 5:2433–2440. https://doi.org/10.1111/j.1600-6143.2005.01040.x

    Article  Google Scholar 

  115. Singh T, Peery S, Astor BC et al (2019) Cause of end-stage renal disease is not a risk factor for cytomegalovirus infection after kidney transplant. Transpl Proc 51:1810–1815. https://doi.org/10.1016/j.transproceed.2019.02.029

    Article  Google Scholar 

  116. Dedinská I, Laca Ľ, Miklušica J et al (2016) Correlation between CMV infection and post-transplantation new-onset diabetes mellitus. Int J Organ Transpl Med 7:173–182

    Google Scholar 

Download references

Acknowledgements

I would like to express our gratitude to the Ministry of Science and Technology of the People's Republic of China for their generous financial support, as well as to acknowledge the invaluable technical assistance provided by the school library. I express my sincere gratitude to Professor Yunlan Jiang for his invaluable advice and guidance, which greatly enhanced the quality of this research. Additionally, I would like to extend my appreciation to Tao Li, Xiaodong Yi, Shang Song, and Jing Kang for their valuable assistance in data collection.

Funding

The Ministry of Science and Technology of China’s initiative on "Active health and aging Science and technology Response". (2020YFC2003104).

Author information

Authors and Affiliations

  1. College of Nursing, Chengdu University of Traditional Chinese Medicine, No.37 Shi-er-qiao Road, Chengdu City, 610075, Sichuan Province, China

    Qiufeng Du, Tao Li, Xiaodong Yi, Shuang Song & Jing Kang

  2. Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, No.39 Shi-er-qiao Road, Chengdu City, 610072, Sichuan Province, China

    Yunlan Jiang

Authors
  1. Qiufeng Du
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tao Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Xiaodong Yi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Shuang Song
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jing Kang
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yunlan Jiang
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Qiufeng Du was responsible for the conception, design, analysis and interpretation of the results, as well as the writing of the paper. Tao Li and Xiaodong Yi were responsible for data collection and organization. Shuang Song and Jing Kang were in charge of statistical processing. Yunlan Jiang conducted feasibility analysis of the article, had overall responsibility for it, ensured quality control, and performed proofreading.

Corresponding author

Correspondence to Yunlan Jiang.

Ethics declarations

Conflict of interest

The authors have no potential conflicts of interest to disclose.

Date of submission

This study was submitted on October 17, 2023.

Research involving Human Participants and/or Animals

Not applicable.

Informed consent

Not applicable.

Additional information

Managed by Giuseppe Pugliese.

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Appendices

Appendix 1

figure a

Appendix 2

Appendix 1: Search strategy

Database

Index and keyword terms

PubMed

("Kidney Transplantation"[Mesh Terms] OR ("Renal Transplantation"[Title/Abstract] OR "Renal Transplantations"[Title/Abstract] OR "Transplantations, Renal"[Title/Abstract] OR "Transplantation, Renal"[Title/Abstract] OR "Grafting, Kidney"[Title/Abstract] OR "Kidney Grafting"[Title/Abstract] OR "Transplantation, Kidney"[Title/Abstract] OR "Kidney Transplantations"[Title/Abstract] OR "Transplantations, Kidney"[Title/Abstract] AND ("Diabetes Mellitus"[Mesh Terms] OR "Diabetes Insipidus"[Mesh Terms] OR "diabetes mellitus"[Title/Abstract] OR "diabetes insipidus"[Title/Abstract] OR "Diabete*"[Title/Abstract] OR "Diabetic*"[Title/Abstract] OR "post-transplant diabetes mellitus"[Title/Abstract] OR("new-onset diabetes"[Title/Abstract] OR "new-onset diabetes mellitus"[Title/Abstract] OR "new-onset diabetes after transplantation"[Title/Abstract] OR "new-onset diabetes mellitus after transplantation"[Title/Abstract] OR "PTDM"[Title/Abstract] OR "NODAT"[Title/Abstract] AND ("prevalence"[MeSH Terms] OR "incidence"[MeSH Terms] OR "epidemiology"[MeSH Terms] OR "prevalence*"[Title/Abstract] OR "occurrence*"[Title/Abstract] OR "frequenc*"[Title/Abstract] OR "incidence*"[Title/Abstract] OR "epidemiology*"[Title/Abstract])

Web of science

(ALL = ("kidney transplantation" OR "renal transplantation") AND ALL = ("diabetes mellitus" OR "diabete*" OR "diabetic*" OR "post-transplant diabetes mellitus" OR "new-onset diabetes" OR "new-onset diabetes mellitus" OR "new-onset diabetes after transplantation" OR "new-onset diabetes mellitus after transplantation" OR "PTDM" OR "NODAT") AND ALL = ("prevalence*" OR "occurrence*" OR "frequenc*" OR "incidence*" OR "epidemiology*")

EMBASE

('kidney transplantation':exp OR 'kidney transplantation':ti,ab OR 'renal transplantation':ti,ab) AND ('diabetes mellitus':exp OR 'diabetes mellitus':ti,ab OR 'diabete*':ti,ab OR 'diabetic*':ti,ab OR 'post-transplant diabetes mellitus':ti,ab OR 'new-onset diabetes':ti,ab OR 'new-onset diabetes mellitus':ti,ab OR 'new-onset diabetes after transplantation':ti,ab OR 'new-onset diabetes mellitus after transplantation':ti,ab OR 'PTDM':ti,ab OR 'NODAT':ti,ab) AND ('prevalence':exp OR 'incidence':exp OR 'frequency':exp OR 'epidemiology':exp OR prevalence:ti,ab OR incidence*:ti,ab OR occurrence*:ti,ab OR frequenc*:ti,ab OR epidemiology*:ti,ab)

The Cochrane Library

(MeSH descriptor: [Kidney Transplantation] OR ("kidney transplantation"):ti,ab,kw OR ("renal transplantation"):ti,ab,kw) AND (MeSH descriptor: [Diabetes Mellitus] OR ("diabetes mellitus"):ti,ab,kw OR ("diabete*"):ti,ab,kw OR ("diabetic*"):ti,ab,kw OR ("post-transplant diabetes mellitus"):ti,ab,kw OR ("new-onset diabetes"):ti,ab,kw OR ("new-onset diabetes mellitus"):ti,ab,kw OR ("new-onset diabetes after transplantation"):ti,ab,kw OR ("new-onset diabetes mellitus after transplantation"):ti,ab,kw OR ("PTDM"):ti,ab,kw OR ("NODAT"):ti,ab,kw) AND (MeSH descriptor: [Prevalence] OR ("prevalence*"):ti,ab,kw OR ("occurrence*"):ti,ab,kw OR ("frequenc*"):ti,ab,kw OR ("incidence*"):ti,ab,kw OR ("epidemiology*"):ti,ab,kw)

Appendix 3

See Table 3 and 4.

Table 3 Quality assessment of studies included based on the AHRQ tool
Full size table
Table 4 Quality assessment of studies included based on the NOS tool
Full size table

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Du, Q., Li, T., Yi, X. et al. Prevalence of new-onset diabetes mellitus after kidney transplantation: a systematic review and meta-analysis. Acta Diabetol (2024). https://doi.org/10.1007/s00592-024-02253-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s00592-024-02253-w

Keyword

Search

Navigation