Effects of New Onset Diabetes and Dyslipidemia on the Allograft

The principal risk factors for cardiovascular mortality posttransplantation are hyperglycemia, hypertriglyceridemia, obesity, and smoking. We assessed the risk factors for new-onset diabetes and dyslipidemia and their effects on the function and histopathologic changes in the allografts at 1 year posttransplantation. In regard to immunosuppressive therapy, new onset diabetes mellitus was significantly more frequent among patients prescribed tacrolimus, whereas subjects who received cyclosporine A showed a significantly higher incidence of dyslipidemia. In regard to allograft function, a significant difference was noted at year 1 after transplantation. When assessing morphologic changes in the kidney, we observed significantly more frequent interstitial fibrosis/tubular atrophy in all 3 groups compared with normal function patients. Our clinical study suggested that at year 1 after transplantation the allograft function is already impaired in the presence of both medical conditions (diabetes and dyslipidemia). However, in regard to morphology, a single condition (diabetes or dyslipidemia) is sufficient to produce histologic changes in the kidney.