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Pretransplant HbA1c Is a Useful Predictor for the Development of New-Onset Diabetes in Renal Transplant Recipients Receiving No or Low-Dose Erythropoietin.

Tokodai K, Amada N, Haga I, Nakamura A, Kashiwadate T, Kawagishi N, Ohuchi N - Int J Endocrinol (2014)

Bottom Line: Seventeen patients (14.3%) developed NODAT within 1 year of transplantation.Receiver-operating characteristic analysis revealed a cut-off value of 5.2% with an optimal sensitivity of 64% and specificity of 78% for predicting NODAT.Conclusions.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Sendai Shakaihoken Hospital, Sendai 980-8574, Japan ; Division of Transplantation, Reconstruction and Endoscopic Surgery, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan.

ABSTRACT
Aims. To evaluate the predictive power of pretransplant HbA1c for new-onset diabetes after transplantation (NODAT) in kidney transplant candidates, who had several predispositions for fluctuated HbA1c levels. Methods. We performed a retrospective study of 119 patients without diabetes who received kidney transplantation between March 2000 and January 2012. Univariate and multivariate logistic regression analyses were used to investigate the association of several parameters with NODAT. Predictive discrimination of HbA1c was assessed using a receiver-operating characteristic curve. Results. Seventeen patients (14.3%) developed NODAT within 1 year of transplantation. Univariate logistic regression analysis revealed that recipient age, gender, and HbA1c were predictors of NODAT. In the multivariate analysis, the association between pretransplant HbA1c and NODAT development did not reach statistical significance (P = 0.07). To avoid the strong influence of high-dose erythropoietin on HbA1c levels, we performed subgroup analyses on 85 patients receiving no or low-dose (≤6000 IU/week) erythropoietin. HbA1c was again an independent predictor for NODAT. Receiver-operating characteristic analysis revealed a cut-off value of 5.2% with an optimal sensitivity of 64% and specificity of 78% for predicting NODAT. Conclusions. Our results reveal that the pretransplant HbA1c level is a useful predictor for NODAT in patients receiving no or low-dose erythropoietin.

No MeSH data available.


Related in: MedlinePlus

The receiver-operating characteristic curve of pretransplant HbA1c. The cut-off point of the HbA1c level was 5.2%, which was derived on the basis of maximizing sensitivity and specificity. AUC: area under the receiver-operating characteristic curve.
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fig2: The receiver-operating characteristic curve of pretransplant HbA1c. The cut-off point of the HbA1c level was 5.2%, which was derived on the basis of maximizing sensitivity and specificity. AUC: area under the receiver-operating characteristic curve.

Mentions: For 29 of the 119 patients included in this study, EPO doses were > 6,000 IU/week; the EPO doses of 5 patients were not available. Therefore, these 34 patients were excluded from the subgroup analyses of patients receiving no or low-dose EPO. Of the 85 patients that were included, 11 patients (12.9%) developed NODAT. Multivariate logistic regression subanalysis revealed that the pretransplant HbA1c level was an independent predictor for the development of NODAT (Table 3). The ROC analyses showed that the area under the ROC curve was 0.75 and the cut-off level of HbA1c which gave the maximum sensitivity and specificity was 5.2% (Figure 2). The sensitivity, specificity, positive predictive value, and negative predictive value of HbA1c at the cut-off point were 64%, 78%, 30%, and 94%, respectively (Table 4).


Pretransplant HbA1c Is a Useful Predictor for the Development of New-Onset Diabetes in Renal Transplant Recipients Receiving No or Low-Dose Erythropoietin.

Tokodai K, Amada N, Haga I, Nakamura A, Kashiwadate T, Kawagishi N, Ohuchi N - Int J Endocrinol (2014)

The receiver-operating characteristic curve of pretransplant HbA1c. The cut-off point of the HbA1c level was 5.2%, which was derived on the basis of maximizing sensitivity and specificity. AUC: area under the receiver-operating characteristic curve.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4216713&req=5

fig2: The receiver-operating characteristic curve of pretransplant HbA1c. The cut-off point of the HbA1c level was 5.2%, which was derived on the basis of maximizing sensitivity and specificity. AUC: area under the receiver-operating characteristic curve.
Mentions: For 29 of the 119 patients included in this study, EPO doses were > 6,000 IU/week; the EPO doses of 5 patients were not available. Therefore, these 34 patients were excluded from the subgroup analyses of patients receiving no or low-dose EPO. Of the 85 patients that were included, 11 patients (12.9%) developed NODAT. Multivariate logistic regression subanalysis revealed that the pretransplant HbA1c level was an independent predictor for the development of NODAT (Table 3). The ROC analyses showed that the area under the ROC curve was 0.75 and the cut-off level of HbA1c which gave the maximum sensitivity and specificity was 5.2% (Figure 2). The sensitivity, specificity, positive predictive value, and negative predictive value of HbA1c at the cut-off point were 64%, 78%, 30%, and 94%, respectively (Table 4).

Bottom Line: Seventeen patients (14.3%) developed NODAT within 1 year of transplantation.Receiver-operating characteristic analysis revealed a cut-off value of 5.2% with an optimal sensitivity of 64% and specificity of 78% for predicting NODAT.Conclusions.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Sendai Shakaihoken Hospital, Sendai 980-8574, Japan ; Division of Transplantation, Reconstruction and Endoscopic Surgery, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan.

ABSTRACT
Aims. To evaluate the predictive power of pretransplant HbA1c for new-onset diabetes after transplantation (NODAT) in kidney transplant candidates, who had several predispositions for fluctuated HbA1c levels. Methods. We performed a retrospective study of 119 patients without diabetes who received kidney transplantation between March 2000 and January 2012. Univariate and multivariate logistic regression analyses were used to investigate the association of several parameters with NODAT. Predictive discrimination of HbA1c was assessed using a receiver-operating characteristic curve. Results. Seventeen patients (14.3%) developed NODAT within 1 year of transplantation. Univariate logistic regression analysis revealed that recipient age, gender, and HbA1c were predictors of NODAT. In the multivariate analysis, the association between pretransplant HbA1c and NODAT development did not reach statistical significance (P = 0.07). To avoid the strong influence of high-dose erythropoietin on HbA1c levels, we performed subgroup analyses on 85 patients receiving no or low-dose (≤6000 IU/week) erythropoietin. HbA1c was again an independent predictor for NODAT. Receiver-operating characteristic analysis revealed a cut-off value of 5.2% with an optimal sensitivity of 64% and specificity of 78% for predicting NODAT. Conclusions. Our results reveal that the pretransplant HbA1c level is a useful predictor for NODAT in patients receiving no or low-dose erythropoietin.

No MeSH data available.


Related in: MedlinePlus