Risk Factors for Developing Posttransplant Diabetes After Pediatric Kidney Transplant in a Canadian Tertiary Care Children’s Hospital Between 1995 and 2016

Posttransplant diabetes mellitus (PTDM) is a serious complication in kidney transplant recipients (KTRs) due to its negative impact on graft and patient survival. Although reported in 3% to 20% of pediatric KTRs, it has not been as well characterized in adults. In this study we describe incidence and risk factors associated with development of PTDM in pediatric KTRs. This work is a retrospective cohort study of nondiabetic pediatric patients, aged 6 months to 19 years, who underwent a first kidney transplant during 1995 to 2016. We estimated the cumulative incidence rate and used multivariable logistic regression to identify the diabetogenic risk factors for PTDM. A total of 142 KTRs were included in this study. The cumulative incidence of PTDM was 31% and 14.1% in the first and second year posttransplant, respectively. Significant risk factors for PTDM in the first year after transplant included: dysglycemia in the first 8 to 30 days posttransplant (adjusted odds ratio [aOR], 3.02; 95% confidence interval [CI], 1.21 to 7.53; p=0.018) and use of sirolimus in the first 30 days posttransplant (aOR, 5.33; 95% CI, 1.16 to 24.35; p=0.031). No significant association was found with typical diabetogenic factors. The incidence of PTDM is high among pediatric KTRs. Independent risk factors associated with PTDM included meeting the criteria for dysglycemia or diabetes and sirolimus use in the first month posttransplant. Typical diabetogenic risk factors for type 2 diabetes were not associated with increased risk. This study provides valuable information for posttransplant medical care and future research. Le diabète sucré post-transplantation (DSPT) est une complication sérieuse chez les receveurs d’une greffe de rein (RGR) en raison de ses répercussions négatives sur la greffe et la survie du patient. Bien que cette complication soit signalée chez 3 % à 20 % des RGR, le taux n’a pas été bien établi chez les adultes. Dans la présente étude, nous décrivons l’incidence et les facteurs de risque associés à l’apparition du DSPT chez les RGR en pédiatrie. Ces travaux constituent une étude de cohorte rétrospective auprès de patients non diabétiques de la pédiatrie, âgés de 6 mois à 19 ans, qui ont subi une greffe de rein entre 1995 et 2016. Nous avons estimé le taux d’incidence cumulée et utilisé la régression logistique multivariable pour déterminer les facteurs de risque diabétogène de DSPT. Un total de 142 RGR ont participé à cette étude. L’incidence cumulée du DSPT ét