Surgical Stress Hyperglycemia Associated With New-Onset Diabetes in Living Kidney Donors

The aim of this study is to investigate the frequency and risk factors of new-onset diabetes after donation in kidney donors without diabetes. Living donors of kidney transplants between 1998 and 2016 were evaluated. To detect the blood glucose profile of the donors, preoperative fasting glucose (pro-G), nephrectomy evening glucose (nG), and postoperative day 1 fasting glucose (post-G) values were measured. A total of 195 cases were included in the study. The mean follow-up time in months ± SD (range) was 56 ± 45 (12–215). Of these, 28 (14.3%) donors developed diabetes. The pro-G (103 ± 7.6 vs 93 ± 9.0), nG (208 ± 122 vs 163 ± 67) and post-G (121 ± 25 vs 111 ± 21) values of the donors with new-onset diabetes were higher. Nineteen donors (9.7%) had normal pro-G, nG, and post-G values (group A). However, there were 153 (78.5%) cases with at least 1 abnormal value (group B) and 25 (12.8%) cases that had abnormal values in all (pro-G, nG, and post-G) measurements (group C). The incidence of new-onset diabetes was 0 (0%) in group A, 11% in group B, and 48% in group C (P < .001). In multiple regression analysis, pro-G (Exp[B], 1.08; 95% CI, 1.04–1.13; P < .001) and basal glomerular filtration rate (Exp[B], 0.96; 95% CI, 0.94–0.99; P < .01) independently associated with new-onset diabetes. In kidney donors without a history of diabetes, the development of diabetes after donor nephrectomy is an important problem. Pre- and postoperative blood glucose levels provide important information to predict these cases.