Pretransplant risk score for new-onset diabetes after kidney transplantation

Harini A. Chakkera, E. Jennifer Weil, Christine M. Swanson, Amylou C. Dueck, Raymond L. Heilman, Kunam S. Reddy, Khaled Hamawi, Hasan Khamash, Adyr A. Moss, David C. Mulligan, Nitin Katariya, William C. Knowler

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44 Scopus citations

Abstract

OBJECTIVE - New-onset diabetes after kidney transplantation (NODAT) has adverse clinical and economic implications. A risk score for NODAT could help identify research subjects for intervention studies. RESEARCH DESIGN AND METHODS - We conducted a single-center retrospective cohort study using pretransplant clinical and laboratory measurements to construct a risk score for NODAT. NODAT was defined by hemoglobin A 1c (HbA 1c) ≥6.5%, fasting serum glucose ≥126mg/dL, or prescribed therapy for diabetes within 1 year posttransplant. Three multivariate logistic regression models were constructed: 1) standard model, with both continuous and discrete variables; 2) dichotomous model, with continuous variables dichotomized at clinically relevant cut points; and 3) summary score defined as the sum of the points accrued using the terms from the dichotomous model. RESULTS - A total of 316 subjects had seven pretransplant variables with P < 0.10 in univariate logistic regression analyses (age, planned corticosteroid therapy posttransplant, prescription for gout medicine, BMI, fasting glucose and triglycerides, and family history of type 2 diabetes) that were selected for multivariate models. Areas under receiver operating curves for all three models were similar (0.72, 0.71, and 0.70). A simple risk score calculated as the sum of points from the seven variables performed as well as the other two models in identifying risk of NODAT. CONCLUSIONS - A risk score computed from seven simple pretransplant variables can identify risk of NODAT.

Original languageEnglish (US)
Pages (from-to)2141-2145
Number of pages5
JournalDiabetes care
Volume34
Issue number10
DOIs
StatePublished - Oct 1 2011

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ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

Cite this

Chakkera, H. A., Weil, E. J., Swanson, C. M., Dueck, A. C., Heilman, R. L., Reddy, K. S., Hamawi, K., Khamash, H., Moss, A. A., Mulligan, D. C., Katariya, N., & Knowler, W. C. (2011). Pretransplant risk score for new-onset diabetes after kidney transplantation. Diabetes care, 34(10), 2141-2145. https://doi.org/10.2337/dc11-0752