New-Onset Diabetes After Kidney Transplantation: Prevalence, Risk Factors, and Management
Sarno G et al. – Once New–Onset Diabetes After Transplantation has been diagnosed, the administration of specific anti–hyperglycemic therapy is mandatory to reach a tight glycemic control, which contributes to significantly reduce posttransplant mortality and morbidity.
- New-Onset Diabetes After Transplantation (NODAT) is an increasingly recognized severe metabolic complication of kidney transplantation causing lower graft function and survival and reduced long-term patient survival mainly due to cardiovascular events.
- The real incidence of NODAT after kidney transplantation is difficult to establish, because different classification systems and definitions have been employed over the years.
- Several risk factors, already present before or arising after transplantation, in particular the employed immunosuppressive regimens, have been related to the development of NODAT.
- However the responsible pathogenic mechanisms are still far to be perfectly known.
- Awareness of NODAT and of the NODAT-related factors is of paramount importance for the clinicians in order to individuate higher risk patients and arrange screening strategies.
- The risk of NODAT can be reduced by planning preventive measures and by tailoring immunosuppressive regimens according to the patient characteristics.