590
A total of 846 renal transplantations,
713 living-related (LRT) and 133 cadaveric donor (CRT), were performed at
our center between October 1985 and January 1998. All patients received
the same immnunosuppressive drug regimen of 5 mg/kg cyclosporine, 1 mg/kg
prednisolone, and 2-2.5 mg/kg azathioprine. Rejection episodes were
treated with steroid pulse therapy (500 mg methylprednisolone i.v. daily
for 3 days ) and/or OKT3 treatment (5 mg/day). Our outpatient department
routinely controls 291 of these patients. Post-transplantation diabetes
mellitus (PTDM) was diagnosed in 18 (6.1%) kidney recipients who were
known to be nondiabetic prior to transplantation. We performed a
retrospective study of these cases looking at various parameters,
including demographics and historical background, HLA typing, and
laboratory findings. LRT had been performed in 15 patients and the
remaining 3 had undergone CRT. The mean age of the individuals with PTDM
was 34.6 years, and there were 14 male and 4 female patients. Two patients
who were second-degree relatives had a family history of diabetes
mellitus. Four (22.2%) of the PTDM patients required insulin treatment,
while a diabetic oral diet was adequate for regulating blood glucose
levels in the other 14 individuals. None of the patients received oral
anti-diabetic medication. Steroid pulse treatment had been administered to
12 of the 18 (66.6%) individuals at a mean steroid dosage of 2,270.8 mg.
All patients who received insulin treatment had also undergone steroid
pulse therapy. Comparing the PTDM group to nondiabetic renal graft
recipients, the frequency of steroid pulse treatment and dosage of steroid
was higher for the PTDM group. Kidney recipients with PTDM had a mean
blood glucose level of 145.8 mg/dl, serum creatinine levels for the PTDM
and control groups were 1.66 mg/dl and 154 mg/dl, respectively (p >
0.05), and the groups' respective 5-year graft survival rates were 66.6%
and 88.8% (p < 0.005). HLA groups-A3 and B5l were the most frequent
tissue types identified in the PTDM individuals, however, we were unable
to pinpoint any specific HLA association in the patient group. In
conclusion, although there were no significant differences in serum
creatinine levels between the PTDM and control groups, the graft survival
rate was significantly lower for those afflicted with PTDM.