928-P: Dysglycemia in Patients without Diabetes after Renal Transplantation

Background: Patients without a prior history of diabetes often experience post-operative hyperglycemia after undergoing renal transplantation. Hyperglycemia in the immediate post-transplant period has been associated with increased risk for infection, graft failure and hospital readmission.

Methods: We performed a retrospective review of all adult patients undergoing renal transplantation at a single tertiary referral center from January 1 - December 31, 2019.

Results: Of the 292 patients, 191 (65.2%) did not have a history of diabetes. Of these, 83 (43.5%) were female (mean ±SD age 46.3 ±14.7 years) while 1 (56.5%) were male (mean ±SD age 47.9 ±15.5 years) . The percentage of post-operative days (POD) while hospitalized with any hyperglycemia (≥180 mg/dL) was 55.5% (female 51.8%, male 58.3%) with the highest average blood glucose on POD1 among all patients. The mean±SD point of care (POC) glucose on POD0, 1, 2 and 3 was 123.4±31.5, 151.1±28.6, 139.8±29.7, and 117.4±28.9 mg/dL, respectively (n = 181, 145, 141, and 126 for respective days) . As compared with those without hyperglycemia, patients with any detected hyperglycemia up to POD5 had numerically higher percentage of hospital acquired infection (2.1% vs. 1%) , admission to the intensive care unit (7.9% vs. 3.7%) , and 30-day readmission (20.4% vs. 10.5%) . The percentage of post-operative days with POC glucose <70 mg/dl was 7.9% (female 8.4%, male 7.4%) .

Conclusions: Patients without a history of diabetes who undergo renal transplantation experience hyperglycemia during the majority of days while hospitalized peri-transplant. Further analysis is needed to determine optimal insulin dosing strategies to improve glycemic control in this population.