Impaired glucose homeostasis in renal transplant recipients receiving basiliximab

Nephrol Dial Transplant. 2010 Apr;25(4):1289-93. doi: 10.1093/ndt/gfp617. Epub 2009 Nov 23.

Abstract

Background: The pathogenesis of new onset diabetes after transplantation (NODAT) is multifactorial. Suppression of regulatory T lymphocytes may have a negative impact on pancreatic beta-cells. Induction with basiliximab affects regulatory T-cell function and may therefore, theoretically, also affect glucose homeostasis in renal transplant recipients.

Methods: All kidney recipients > or =50 years of age without diabetes mellitus transplanted from 1 January 2005 to 31 December 2007 were included in a single-centre retrospective study. Immunosuppression consisted of steroids, mycophenolate mofetil and cyclosporine. Basiliximab was introduced as induction therapy 1 January 2007. An oral glucose tolerance test (OGTT) was performed in all patients 10 weeks post-transplant.

Results: A total of 264 patients were recruited. One hundred and thirty-four patients received basiliximab. In the basiliximab group, 51.5% developed NODAT, impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) versus 36.9% in the group without induction therapy (P = 0.017). In recipients with normal OGTT, the mean fasting glucose at 10 weeks was 5.18 mmol/l (SD: 0.54) in the basiliximab group (n = 65) and 4.84 mmol/l (SD: 0.64) in the no induction group (n = 82) (P = 0.001).

Conclusion: Use of basiliximab as induction therapy may be associated with impaired glucose homeostasis after kidney transplantation.

Publication types

  • Clinical Trial

MeSH terms

  • Antibodies, Monoclonal / adverse effects*
  • Basiliximab
  • Blood Glucose / metabolism
  • Female
  • Glucose / metabolism*
  • Glucose Intolerance*
  • Glucose Tolerance Test
  • Graft Survival / drug effects
  • Homeostasis / drug effects*
  • Humans
  • Immunosuppressive Agents / adverse effects*
  • Kidney Transplantation*
  • Male
  • Middle Aged
  • Recombinant Fusion Proteins / adverse effects*
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Antibodies, Monoclonal
  • Blood Glucose
  • Immunosuppressive Agents
  • Recombinant Fusion Proteins
  • Basiliximab
  • Glucose