Investigation on the validity of fasting blood glucose and glucose tolerance test in fifth days after kidney transplantation for anticipating diabetes mellitus

Kidney transplantation is the best replacement therapy for patients with end stage renal disease at present. Cardiovascular disease is the most important cause of mortality among these patients. Also chronic allograft nephropathy is to some extent a manifestation of cardiovascular pathology. Diabetes mellitus is the most influencing factor both in cardiovascular disease and chronic allograft nephropathy. Prediction and timely detection of new onset diabetes after kidney transplant can help therapies in appropriate management and manipulation of modifiable risk factors of this phenomenon.
The present study has been performed upon 66 chronic renal failure patients undergone kidney transplantation during a 4 months period at Imam Reza (p.b.u.h) university hospital of Mashhad –IRAN. On day 5 and at month 6 post transplantation, fasting blood glucose measured and a 75 g , glucose tolerance test performed. Another fasting blood glucose recorded at week 12. The immunosuppression regimen was the same for all. Exclusion criteria were: History of Diabetes mellitus, Graft rejection, Hepatitis C, Infection and need for immunosuppressive drug modification. Sensitivity and specificity analysis test used to evaluate the ability of day 5-post transplantation fasting blood glucose and glucose tolerance test to predict the occurrence of post transplantation diabetes mellitus. (PTDM)
6 out of 66(9.3%) patients had day 5 fasting blood glucose > 126 mg/dl while the remaining 60 had values 126 mg/dl six months post transplantation and indeed developed PTDM. Therefore sensitivity and specifity of 5th day fasting blood glucose as a predictor Of PTDM equals one (100% ) based on our results. The results were similar for glucose tolerance test .
Day 5 post transplantation fasting blood glucose is a good predictor of PTDM and can be used as a modifier to individualize the management of kidney transplant recipients.