Abstract
New-onset diabetes mellitus after kidney transplantation (NODAT) is widely acknowledged to be associated with increased morbidity and mortality, as well as poor quality of life. Clear evidence links the occurrence of NODAT to accelerated progression of some macrovascular and/or microvascular complications. However, the evidence that some complications commonly attributed to diabetes mellitus occur in the context of transplantation lacks robustness. Certain complications are transplantation-specific and prevalent, but others are not frequently observed or documented. For this reason, it is essential that clinicians are aware of the array of potential complications associated with NODAT in kidney allograft recipients. Rather than simply translating evidence from the general population to the high-risk transplant recipient, this Review aims to provide specific guidance on diabetes-related complications in the context of a complex transplantation environment.
Key Points
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New-onset diabetes mellitus after kidney transplantation (NODAT) is associated with numerous short-term and long-term complications
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Diabetes-related complications in patients with NODAT probably involve both general and transplant-specific components
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The array of diabetes-related complications observed in the general population might not be directly applicable to the transplant population
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Some evidence suggests that the evolution of diabetes-related complications is accelerated after kidney transplantation
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Management of NODAT complications requires a multifactorial rather than glycemia-centered approach, conducted in partnership with established diabetes frameworks, to ensure optimal care for transplant recipients
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A. Sharif contributed to researching data for the article, discussion of the article content, writing the article, and reviewing and/or editing the manuscript before submission. K. Baboolal contributed to discussion of the article content and reviewing and/or editing the manuscript before submission.
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Sharif, A., Baboolal, K. Complications associated with new-onset diabetes after kidney transplantation. Nat Rev Nephrol 8, 34–42 (2012). https://doi.org/10.1038/nrneph.2011.174
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DOI: https://doi.org/10.1038/nrneph.2011.174
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