Abstract
Objective
In post-transplant period, glucose metabolism is altered mostly due to immunsupressive agents and fast weight gain. Insulin resistance, impaired glucose tolerance test results and new onset diabetes after transplantation are detected pathologies. Moreover, this altered glucose metabolism could be a cause of cardiovascular complications, deterioration of graft problems and morbidities. Early detection and appropriate treatment plan have importance to reduce risk and complication rate. In this study, we aimed to assess glucose metabolism changes in children between pre-and post-transplantation period.
Methods
We conducted a retrospective study with the clinical and laboratory findings of 36 pediatric kidney transplant patients in our clinic. Last laboratory assesment before transplantation and also, clinical and laboratory parameters in post-transplant period were taken from evaluation records according to our annually assessment protocol.
Results
In 9 (25%) patients have altered glucose metabolism (new onset diabetes mellitus after transplantation in 2 patients, insulin resistance in 3 patients, glucose intolerance in 4 patients). There was a positive corelation between age, being on chronic periton dialysis programme, the need for insulin treatment in perioperative and first 24 hours in post-transplant period, low glomerular filtration rate, high body mass index, begining of puberty and new onset diabetes mellitus after transplantation, insulin resistance and glucose intolerance (p<0.05).
Conclusion
In conclusion, altered glucose metabolism in pediatric kidney transplant patients is an important co-morbidity. We believe that risk assessment for glucose metabolism disorders should be start before transplantation and continued annually after transplantation.
Keywords: Diabetes mellitus, glucose intolerance, insulin resistance, kidney transplantation, pediatric
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