Comprehensive lifestyle modification as complementary therapy to prevent and manage post-transplant diabetes mellitus*

ORIGINAL ARTICLE

Comprehensive lifestyle modification as complementary therapy to prevent and manage post-transplant diabetes mellitus*

Katarzyna Madziarska 1 , Katarzyna Hap 2 , Oktawia Mazanowska 1 , Edyta Sutkowska 2

1. Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Poland,
2. Department and Division of Medical Rehabilitation, Wroclaw Medical University, Poland,

Published: 2021-04-08
DOI: 10.5604/01.3001.0014.8311
GICID: 01.3001.0014.8311
Available language versions: en pl
Issue: Postepy Hig Med Dosw 2021; 75 : 238-245

 

Abstract

Post-transplant diabetes mellitus (PTDM) is one from the most common metabolic complications after kidney transplantation. PTDM develops in the early period after transplantation. The risk factors of PTDM are carbohydrate imbalances occurring in the patient prior to transplantation, surgery and the inclusion of immunosuppressive treatment. Kidney transplant patients tend to gain weight, which is associated with an increased risk of post-transplant diabetes, cardiovascular diseases and abnormal transplanted kidney function. Patients after kidney transplantation should be advised to adopt a lifestyle based on a proper diet, exercise, weight control and smoking cessation. The strategy to reduce the risk factors for PTDM development should start before transplantation and continue after kidney transplantation. A targeted, non-pharmacological approach to patients already during the dialysis period may have a significant impact on reducing post-transplantation diabetes. Lifestyle interventions can effectively reduce the risk of development and inhibit the progression of post-transplantation diabetes. The article describes elements of comprehensive non-pharmacological management based on available knowledge of rehabilitation, dietetics and psychology.

References

  • 1. Aker S., Ivens K., Grabensee B., Heering P.: Cardiovascular riskfactors and diseases after renal transplantation. Int. Urol. Nephrol.,1998; 30: 777–788
    Google Scholar
  • 2. Aksoy N.: Weight gain after kidney transplant. Exp. Clin. Transplant.,2016; 3: 138–140
    Google Scholar
  • 3. Anderson C., Nguyen H., Rifkin D.: Nutrition intervention inchronic kidney disease. Med. Clin. North Am., 2016;100: 1265–1283
    Google Scholar
  • 4. Arend S.M., Mallat M.J., Westendorp R.J., Woude F., Es L.A.: Patientsurvival after renal transplantation; more than 25 years follow-up.Nephrol. Dial. Transplant., 1997; 12: 1672–1679
    Google Scholar
  • 5. Banas M.C., Banas B., Wolf J., Hoffam U., Kruger B., Boger C., OrthS., Kramer B.: Smoking behaviour of patients before and after renaltransplantation. Nephrol. Dial. Transplant., 2008; 23: 1442–1446
    Google Scholar
  • 6. Benomar K., Espirad S., Vahe C., Mapihan K., Jannin A., DharancyS., Hazzan M., Vantyghem M.C.: Post-transplantation diabetes: Treatmentà la carte? Diabetes Metab., 2017; 43: 378–381
    Google Scholar
  • 7. Bergrem A.H., Valderhaug T.G., Hartmann A., Hjelmesaeth J.,Leivestadt T., Bergrem H., Jenssen T.: Undiagnosed diabetes in kidneytransplant candidates: A case-finding strategy. Clin. J. Am. Soc.Nephrol., 2010; 5: 616–622
    Google Scholar
  • 8. Chakkera H.A., Weil E.J., Pham P.T., Pomeroy J., Knowler W.C.: Cannew-onset diabetes after kidney transplant be prevented?. DiabetesCare, 2013; 36: 1406–1412
    Google Scholar
  • 9. Conte C., Secchi A.: Post-transplantation diabetes in kidney transplantrecipients: An update on management and prevention. ActaDiabetol., 2018; 55: 763–774
    Google Scholar
  • 10. Cullen T.J., McCarthy M.P., Lasarev M.R., Barry J.M., StadlerD.D.: Body mass index and the development of new-onset diabetesmellitus or the worsening of pre-existing diabetes mellitus in adultkidney transplant patients. J. Ren. Nutr., 2014; 24: 116–122
    Google Scholar
  • 11. Diaz J., Gich I., Bonfill X., Sola R., Guirado L., Facundo C., SainzZ., Puig T., Silva I., Ballarin J.: Prevalence evolution and impact ofcardiovascular risk factors on allograft and renal transplant patientsurvival. Transplant. Proc., 2009; 41: 2151–2155
    Google Scholar
  • 12. Fong J.V., Moore L.W: Nutrition trends in kidney transplantrecipients: the importance of dietary monitoring and need for evidence-based recommendations. Front. Med., 2018; 5: 302
    Google Scholar
  • 13. Fuhrmann I., Krause R.: Principles of exercising in patients withchronic kidney disease, on dialysis and for kidney transplant recipients.Clin. Nephrol., 2004; 61, Suppl. 1: 14–25
    Google Scholar
  • 14. Gołębiowski T., Weyde W., Kusztal M., Szymczak M., Madziarska K.,Penar J., Wątorek E., Krajewska M., Strempska B., Klinger M.: Physicalexercise in the rehabilitation of dialysis patients. Postępy Hig. Med.Dośw., 2009; 63: 13–22
    Google Scholar
  • 15. Gosmanov A., Dagago-Jack S.: Predicting, managing and preventingnew-onset diabetes after transplantation. Minerva Endocrinol.,2012; 37: 233–246
    Google Scholar
  • 16. Grzeszczak W., Czupryniak L., Cypryk K.: Zalecenia klinicznedotyczące postępowania u chorych na cukrzycę 2011. J. Diab. Pol.,2011; 11: A3
    Google Scholar
  • 17. Hap K., Madziarska K., Hap W., Zmonarski S., Zielińska D., KamińskaD., Banasik M., Kościelska-Kasprzak K., Klinger M., Mazanowska O.: Arefemales more prone than males to become obese after kidney transplantation?.Ann. Transplant., 2019; 24: 57–61
    Google Scholar
  • 18. Hap K., Madziarska K., Zmonarski S., Kamińska D., Magott-ProcelewskaM., Banasik M., Jędrzejak K., Madziarski M., Hap W., KlingerM., Mazanowska O.: Pretransplantation oral glucose tolerance test canprevent posttransplant diabetes mellitus after renal transplantation:preliminary study. Transplant. Proc., 2018; 50: 1776–1780
    Google Scholar
  • 19. Huang M., Lv A., Wang J., Xu N., Ma G., Zhai Z., Zhang B., Gao J.:Exercise training and outcomes in hemodialysis patients: systematicreview and meta-analysis. Am. J. Nephrol., 2019; 50: 240–254
    Google Scholar
  • 20. Hurst F., Altieri M., Patel P., Jindal T., Guy S., Sidawy A., Agodoa L.,Abbot K., Jindall R.: Effect of smoking on kidney transplant outcomes:analysis of the United States Renal Data System. Transplantation,2011; 92: 1101–1107
    Google Scholar
  • 21. Jeanette M.H., Linda S.B.: Comprehensive guide to transplantnutrition. Chicago: American Dietetic Association, 2002; 1st Edition
    Google Scholar
  • 22. Kasiske B., Klinger D.: Cigarette smoking in renal transplant recipients.J. Am. Soc. Nephrol., 2000; 11: 753–759
    Google Scholar
  • 23. Khong M.J., Ping Chong C.: Prevention and management of newonsetdiabetes mellitus in kidney transplantation. Neth. J. Med., 2014;72: 127–134
    Google Scholar
  • 24. KDIGO 2009 Clinical practice gulideline for kidney transplantrecipients. https://kdigo.org/wp-content/uploads/2017/02/KDIGO-2009-Transplant-Recipient-Guideline-English.pdf (11.12. 2019)
    Google Scholar
  • 25. KDIGO 2012 Clinical practice guideline for the evaluation andmanagement of chronic kidney disease. 2013: 1-150. https://kdigo.org/wp-content/uploads/2017/02/KDIGO_2012_CKD_GL.pdf (11.12.2019)
    Google Scholar
  • 26. Madziarska K., Klinger M.: New-onset posttransplant diabetesmellitus begins in the dialysis period. J. Ren. Nutr., 2012; 22: 162–165
    Google Scholar
  • 27. Madziarska K., Weyde W., Krajewska M., Patrzalek D., JanczakD., Kusztal M., Augustyniak-Bartosik H., Szyber P., Kozyra C., KlingerM.: The increased risk of post-transplant diabetes mellitus in peritonealdialysis-treated kidney allograft recipients. Nephrol. Dial.Transplant., 2011; 26: 1396–1401
    Google Scholar
  • 28. McCann L.: Pocket guide to nutrition assessment of the patientwith kidney disease: a precise resource for comprehensive nutritioncare in kidney disease. 5th ed. New York, NY: National KidneyFoundation, 2015: 11–39–11–45
    Google Scholar
  • 29. Nava Billet Tegger: Owner’s manual: Nutrition care for yourkidney transplant. J. Ren. Nutr., 2019; 29: 249–255
    Google Scholar
  • 30. NKF K/DOQI Clinical practice guidelines for nutrition in chronicrenal failure. Am. J. Kidney Dis., 2001; 37: S66–S70
    Google Scholar
  • 31. Obayashi P.: Nutrition basics for adult solid organ transplant – anoverwiew. https://www.todaysdietitian.com/pdf/courses/ObayashiOrganTransplant.pdf (05.12. 2019)
    Google Scholar
  • 32. Orth S.R., Ogata H., Ritz E.: Smoking and the kidney. Nephrol.Dial. Transplant., 2000; 15: 1509–1511
    Google Scholar
  • 33. Painter P., Marcus R.L.: Assessing physical function and physicalactivity in patients with CKD. Clin. J. Am. Soc. Nephrol., 2013;8: 861–872
    Google Scholar
  • 34. Palepu S., Prasad G.V.: New-onset diabetes mellitus after kidneytransplantation: current status and future directions. World J.Diabetes, 2015; 6: 445–455
    Google Scholar
  • 35. Pimentel A.L., Carvalho L.S., Marques S.S., Franco R.F., SilveiroS.P., Manfro R.C., Camargo J.L.: Role of glycated hemoglobin in thescreening and diagnosis of posttransplantation diabetes mellitusafter renal transplantation: A diagnostic accuracy study. Clin. Chim.Acta, 2015; 445: 48–53
    Google Scholar
  • 36. Rocco M.V., Paranandi L., Burrowes J.D., Cockram D.B., DwerJ.T., Kusek J.W., Leung J., Makoff R., Maroni B., Poole D.: Nutritionalstatus in the HEMO Study cohort at baseline. Hemodialysis. Am. J.Kidney Dis., 2002; 39: 245–256
    Google Scholar
  • 37. Samochowiec J., Rogoziński D., Hajduk A., Skrzypińska A., ArentowiczG.: Diagnostyka, mechanizm uzależnienia i metody leczeniauzależnienia od nikotyny. Alkoholizm i Narkomania, 2001; 14:323–340
    Google Scholar
  • 38. Sharif A., Baboolal K.: Complications associated with new-onsetdiabetes after kidney transplantation. Nat. Rev. Nephrol., 2011;8: 34–42
    Google Scholar
  • 39. Sharif A., Moore R.H., Baboolal K.: The use of oral glucose tolerancetests to risk stratify for new-onset diabetes after transplantation:An underdiagnosed phenomenon. Transplantation, 2006;82: 1667–1672
    Google Scholar
  • 40. Sharif A., Moore R., Baboolal K.: Influence of lifestyle modificationin renal transplant recipients with postprandial hyperglycemia.Transplantation, 2008; 85: 353–358
    Google Scholar
  • 41. Takahashi A., Hu S.L., Bostom A.: Physical activity in kidneytransplant recipients: A review. Am. J. Kidney Dis., 2018; 72: 433–443
    Google Scholar
  • 42. Thiem U., Olbramski B., Borchhardt K.: Calcidiol deficiency inend-stage organ failure and after solid organ transplantation: Statusquo. Nutrients, 2013; 5: 2352–2371
    Google Scholar
  • 43. Tzvetanov I., West-Thielke P., D’Amico G., Johnsen M., Ladik A.,Hachaj G., Grazman M., Heller R., Fernhall B., Daviglus M., Solaro M.,Oberholzer J., Gallon L., Benedetti E.: A novel and personalized rehabilitationprogram for obese kidney transplant recipients. Transplant.Proc., 2014; 46: 3431–3437
    Google Scholar
  • 44. Unwin N., Shaw J., Zimmet P., Alberti K.G.: Impaired glucosetolerance and impaired fasting glycaemia: The current status ondefinition and intervention. Diabet. Med., 2002; 19: 708–723
    Google Scholar
  • 45. Woodward R.S., Schnitzler M.A., Baty J., Lowell J.A., Lopez-RocafortL., Haider S., Woodworth T.G., Brenann D.C.: Incidence and costof new onset diabetes mellitus among U.S. wait-listed and transplantedrenal allograft recipients. Am. J. Transplant., 2003; 3: 590–598
    Google Scholar
  • 46. World Health Organization. Global recommendations on physicalactivity for health. Geneva, Switzerland: WHO; 2010. http://apps.who.int/iris/bitstream/10665/44399/1/97892415 99979_eng.pdf (11.12.2019)
    Google Scholar
  • 47. Yavuz A., Tuncer M., Gurkan A., Demirbas A., Suleymanlar G.,Ersoy F., Yakupoglu G.: Cigarette smoking in renal transplant recipients.Transplant. Proc., 2004; 36: 108–110
    Google Scholar
  • 48. Zelle D.M., Klaassen G., van Adrichem E., Bakker S.J., CorpeleijnE., Navis G.: Physical inactivity: A risk factor and target for interventionin renal care. Nat. Rev. Nephrol., 2017; 13: 152–168
    Google Scholar
  • 49. Zelle D.M., Kok T., Dontje M.L.: The role of diet and physicalactivity in post-transplant weight gain after renal transplantation.Clin. Transplant., 2013; 27: E484–E490
    Google Scholar

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