Long-Term Effect of Renal Transplantation and Aging on Hemoglobin A1C Levels: A Case-Control Study in 191 Non-Diabetic Deceased Donor Renal Transplant Recipients

Ann Transplant. 2015 Dec 8:20:729-33. doi: 10.12659/aot.895046.

Abstract

Background: Reduced renal function in patients with chronic kidney disease is linked to insulin resistance; and impairments in glucose homeostasis, as measured by HbA1c levels, are related to cardiovascular events. Recently, aging has been reported to affect HbA1c levels over time in non-diabetic individuals. The objective of this study was to investigate the association between renal function and aging in non-diabetic deceased-donor renal transplant recipients.

Material and methods: A total of 191 patients were analyzed (mean age 50.6±12.2 years, dialysis vintage 6.5±3.1 years, 53.4% male patients). HbA1-c levels were measured on the day of transplantation and on follow-up. The mean follow-up time was 4.9±3.1 years.

Results: Renal transplantation resulted in an increase in eGFR of 38.6±18.9 mL/min/1.73 m2 as compared to baseline levels on dialysis and the mean eGFR on follow-up was 45.5±18.9 mL/min/1.73 m2. HbA1c levels increased significantly from the day of transplantation to the last follow-up (5.3±0.4% to 5.6±0.4%, p<0.0001). Correlation analysis demonstrated non-significant associations between the change in HbA1c levels and the parameters of age and renal transplant function.

Conclusions: In conclusion, we observed a significant increase in HbA1c levels over a 5-year post-transplant follow-up period in non-diabetic deceased-donor renal transplant recipients. In contrast to the non-diabetic general population, the increase in HbA1c observed in this cohort was greater but not associated with aging.

MeSH terms

  • Adult
  • Aging / blood*
  • Cadaver
  • Case-Control Studies
  • Creatinine / blood*
  • Databases, Factual
  • Female
  • Follow-Up Studies
  • Germany
  • Glycated Hemoglobin / metabolism*
  • Graft Rejection
  • Graft Survival
  • Humans
  • Insulin Resistance / physiology
  • Kidney Transplantation / adverse effects
  • Kidney Transplantation / methods*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk Assessment
  • Statistics, Nonparametric
  • Time Factors
  • Tissue Donors
  • Transplant Recipients
  • Treatment Outcome

Substances

  • Glycated Hemoglobin A
  • Creatinine