Data from: Diabetes mellitus and prediabetes on kidney transplant waiting list- prevalence, metabolic phenotyping and risk stratification approach

Background: Despite a significant prognostic impact, little is known about
disturbances in glucose metabolism among kidney transplant candidates. We
assess the prevalence of diabetes mellitus (DM) and prediabetes on kidney
transplant waiting list, its underlying pathophysiology and propose an
approach for individual risk stratification. Methods: All patients on
active kidney transplant waiting list of a large European university
hospital transplant center were metabolically phenotyped. Results: Of 138
patients, 76 (55%) had disturbances in glucose metabolism. 22% of patients
had known DM, 3% were newly diagnosed. 30% were detected to have
prediabetes. Insulin sensitivity and -secretion indices allowed for
identification of underlying pathophysiology and risk factors. Age
independently affected insulin secretion, resulting in a relative risk for
prediabetes of 2.95 (95%CI 1.38-4.83) with a cut-off at 48 years. Body
mass index independently affected insulin sensitivity as a continuous
variable. Conclusions: The prevalence of DM or prediabetes on kidney
transplant waiting list is as high as 55%, with more than one third of
patients previously undiagnosed. Oral glucose tolerance test is mandatory
to detect all patients at risk. Metabolic phenotyping allows for
differentiation of underlying pathophysiology and provides a basis for
early individual risk stratification and specific intervention to improve
patient and allograft outcome.