A report of 5 cases of post-transplantation diabetes mellitus after kidney transplantation in children
10.3760/cma.j.cn421203-20210520-00154
- VernacularTitle:儿童肾移植术后随访期新发糖尿病五例诊治
- Author:
Weijie LI
1
;
Zhiliang GUO
;
Daqiang ZHAO
;
Tianhui PAN
;
Gang CHEN
;
Pei WANG
;
Lan ZHU
Author Information
1. 华中科技大学同济医学院附属同济医院药学部，武汉 430030
- Keywords:
Kidney transplantation;
New onset diabetes after renal transplantation;
Child
- From:
Chinese Journal of Organ Transplantation
2021;42(8):459-463
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To summarize the clinical characteristics and therapeutic drug selection of post-transplantation diabetes mellitus(PTDM)after kidney transplantation in children.Methods:From May 2014 to March 2021, a total of 5 cases(5.38%)of 93 paediatric kidney transplant recipients with a median follow-up period of 34 months were diagnosed with PTDM in our centre.Retrospective data analysis was performed for these 5 paediatric recipients.The characteristics of the disease, treatment data and outcomes were summarized.Among the five paediatric recipients, one was male and four patients were female, ranging the age from 12 to 17 years.All recipients received a tacrolimus-based immunosuppressive regimen with prednisone discontinued no later than 3 months after kidney transplant.Results:The onset of PTDM ranged from 1 month to 46 months(median: 17 months)after transplantation.The blood glucose of two children returned to normal gradually after tacrolimus conversion to cyclosporine, with one of them was given insulin temporarily.Three children received oral hypoglycaemic agents, including one received acarbose, one received metformin, and one received metformin combined with acarbose.After a median follow-up of 6 months, the levels of blood glucose in five children were stable, and there was no significant change in serum creatinine and urine protein.Conclusions:The treatment of PTDM in children should be individualized with considering of age, gender and immunosuppressive regimen. Switch from tacrolimus to cyclosporine is effective. Metformin or other hypoglycemic agentsis helpful when tacrolimus is maintained.
