AUTHOR=Odler Balazs , Huemer Matthias , Schwaiger Elisabeth , Borenich Andrea , Kurnikowski Amelie , Krall Marcell , Hafner-Giessauf Hildegard , Eleftheriadis Georgios , Bachmann Friderike , Faura Anna , José Pérez-Sáez María , Pascual Julio , Budde Klemens , Rosenkranz Alexander R. , Hecking Manfred , Eller Kathrin 

TITLE=Influence of Early Postoperative Basal Insulin Treatment and Post-Transplant Diabetes Mellitus Risk on Health-Related Quality of Life in Kidney Transplant Recipients—An Analysis of Data From a Randomized Controlled Trial

JOURNAL=Transplant International

VOLUME=Volume 36 - 2023

YEAR=2023

URL=https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2023.11370

DOI=10.3389/ti.2023.11370

ISSN=1432-2277

ABSTRACT=Background: Health-related quality of life (HRQOL) improves after kidney transplantation (KT) but declines over time. Studies on the effect of early postoperative basal insulin therapy on HRQOL after KT, especially KTRs at high-risk to develop posttransplant diabetes mellitus (PTDM) are missing. 
Methods: Data from a randomized controlled trial on 148 non-diabetic KTRs were analyzed. HRQOL using the KDQOL-SFTM was compared in KTRs either received early postoperative basal insulin therapy or standard-of-care and in KTRs at risk to develop PTDM. Determinants of HRQOL outcomes were investigated using multivariable linear regression analysis.
Results: Standard-of-care or early basal insulin therapy after KT did not influence HRQOL. Overall, KT improved the mental (MCS) and physical component summary (PCS) scores at 6-months after KT, which remained stable during further follow-up visits. However, patients at high-risk for PTDM had significantly greater impairment in the PCS score (baseline, 24 months) without differences in MCS scores. In the multivariable regression analysis, allograft function and hemoglobin levels were associated with decreased MCS and PCS scores, respectively.
Conclusion: Early basal insulin therapy does not affect HQOL after KT but is negatively influenced by classical clinical factors and PTDM-risk at 24 months after KT, which might be influenced by older age.