Post-transplant diabetes mellitus and renal cell cancer after renal transplantation

• Published in: Nephrology, dialysis, transplantation Vol. 38; no. 6; pp. 1552 - 1559
• Main Authors: Porrini, Esteban, Montero, Nuria, Díaz, Juan Manuel, Lauzurrica, Ricardo, Rodríguez, Juana Oramas, Torres, Irene Silva, Moreso, Francesc, Cruzado, Josep M, Ruiz, Rocío Benítez, Vilaró, Meritxel Ibernon, Lima, Maria Xixiang Molina, Ramchand, Simran Khemlani, Ruiz, Juan Carlos, Gainza de los Rios, Francisco, Alvarez, Carla Rodríguez, Guindo, María del Carmen de Gracia, Macías, Manuel, Vela, David Bonet, Osuna, Antonio, Bayés-Genís, Beatriz, Sanchez, Cristina Aleman, Ruiz, María del Carmen, Rodríguez, Ana Elena Rodríguez, Rollán, Rosa Domínguez, Rinne, Federico González, Sosa, Alejandro Jiménez, Mallén, Patricia Delgado, Rinne, Ana González, Miranda, Domingo Marrero, Torres, Armando
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 31-05-2023
• Subjects: Carcinoma, Renal Cell - complications; Carcinoma, Renal Cell - etiology; Diabetes Mellitus - diagnosis; Diabetes Mellitus - epidemiology; Diabetes Mellitus - etiology; Humans; Kidney Neoplasms - epidemiology; Kidney Neoplasms - etiology; Kidney Transplantation - adverse effects; Male; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Retrospective Studies; Risk Factors; renal cell cancer; diabetes; prediabetes; transplantation
• ISSN: 0931-0509; 1460-2385
• DOI: 10.1093/ndt/gfac291

ABSTRACT
Background
Diabetes is a risk factor for cancer in the general population. However, few data are available on the association between post-transplant diabetes mellitus (PTDM) and cancer after transplantation.
Methods
We analyzed this issue in a Spanish cohort of patients without diabetes before transplantation. PTDM was diagnosed with consensus criteria at 12 months after transplantation and 12 months before the diagnosis of cancer. The association between PTDM and cancer (overall and specific types) was evaluated with regression analysis.
Results
During a follow-up of 12 years (interquartile range 8–14), 85 cases of 603 developed cancer (829/100 000/year) and 164 (27%) PTDM. The most frequent cancers were renal cell cancer (RCC) n = 15, 146/cases/100 000/year), lung (n = 12, 117/cases/100 000/year), colon (n = 9, 88/cases/100 000/year) and prostate (n = 9, 88/cases/100 000/year). In logistic regression, PTDM was not associated with cancer. Eight of the 164 patients with PTDM (4.9%) vs 7 of the 439 without PTDM developed RCC (1.6%) (P = .027). In multivariate analysis, PTDM was independently associated with RCC [odds ratio (OR) 2.92, confidence interval (CI) 1.03–8.27], adjusting for smoking (OR 4.020, 95% CI 1.34–12.02) and other covariates. PTDM was not associated with other types of cancer.
Conclusions
Patients with PTDM must be considered a population at risk for RCC and accordingly, the subject of active surveillance.