New-Onset Diabetes After Renal Transplantation (NODAT): Is It a Risk Factor for Renal Cell Carcinoma or Renal Failure?
Haibo Nie, Wei Wang, Yongbin Zhao, Xiaoming Zhang, Yuansong Xiao, Qinsong Zeng, Changzhen Zhang, Lei Zhang
Department of Urology, General Hospital of Southern Theatre Command of China People’s Liberation Army (CPLA), Guangzhou, Guangdong, China (mainland)
Ann Transplant 2019; 24:62-69
Available online: 2019-02-04
Diabetes mellitus (DM) is a risk factor for renal failure and possibly for renal cell carcinoma (RCC). Post-transplantation DM occurs frequently after solid organ transplantation. We investigated whether new-onset diabetes after renal transplantation (NODAT) is a risk factor for RCC or renal failure.
MATERIAL AND METHODS: Data of 96,699 discharged patients with and without NODAT were extracted from the 2005–2014 Nationwide Inpatient Sample (NIS) database, after excluding patients with DM diagnosed at least 1 year prior to renal transplantation. Main outcomes were RCC diagnosis less than 1-year post-transplantation, RCC stage, and renal failure. Univariate and multivariate regression analyses were performed to identify demographic and clinical factors associated with post-transplantation RCC or renal failure.
RESULTS: Significant differences were found in age and race between patients with and without NODAT (both P<0.001). The renal failure rate was 0.8% (n=1) in NODAT patients and 0.3% (n=314) in those without NODAT. Older age (OR, 1.030; 95% CI: 1.023 to 1.036), male (OR, 1.872; 95% CI: 1.409 to 2.486), Black (OR, 2.199; 95% CI: 1.574 to 3.071) and hospitalization in urban teaching hospitals were associated with increased risk of RCC.
CONCLUSIONS: Analysis of over 90,000 NIS hospitalizations with diagnosis-coded kidney transplantation suggested that NODAT may not be an independent risk factor for RCC and renal failure.
Keywords: Kidney Neoplasms, Kidney Transplantation, Neurology