Statin use is prospectively associated with new onset diabetes after transplantation in renal transplant recipients

Objective: New onset diabetes after transplantation (NODAT) is frequent and worsens graft and patient outcomes in renal transplant recipients (RTR). In the general population statins are diabetogenic. This study investigated whether statins also increase NODAT risk in RTR.

Research design and methods: From a prospective longitudinal study of 606 RTR (functioning allograft >1 year, single academic center, follow-up: median 9.6 [6.6-10.2] years) 95 patients using statins were age- and gender-matched to RTR not on statins (all diabetes-free at inclusion) .

Results: NODAT incidence was 7.2% (73.3% of these on statins). In Kaplan-Meier (log rank test, p=0.017) and COX regression analyses (HR, 3,86 [1.21-12.27], P=0.022) statins prospectively associated with incident NODAT, even independent of several relevant confounders including immunosuppressive medication and biomarkers of glucose homeostasis.

Conclusions: This study demonstrates that statin use is prospectively associated with the development of NODAT in RTR independent of other recognized risk factors.