European Journal of Biomedical and Pharmaceutical Sciences

DETERMINATION OF BLOOD GLUCOSE AMONG KIDNEY ALLOGRAFT RECIPIENT UNDER TACROLIMUS TREATMENT

Noon Nabil Fathalla* and Nasr Aldeen Sheriff

ABSTRACT

Background: A kidney transplant is the transfer of a healthy kidney from one person (the donor) into the body of a person who has little or no kidney activity (the recipient). The loss of kidney function is known as kidney failure. There are three different medications used After having a kidney transplant; Immunosuppressant, which prevent your immune system from rejecting the new kidney, medicines to reduce the risks of taking immunosuppressant and medicines to prevent high blood pressure (hypertension) and high cholesterol, Immunosuppressive agents used to prevent the rejection of transplanted organs and tissues. The most common side effects of Tacrolimus are weakened immune system, headache, insomnia, hand tremor, increased blood pressure, and elevated blood sugar, over dosage may affect kidney function. Post-transplant diabetes mellitus (PTDM) is a complication which takes place after a solid organ transplant, some factors increase the risk of PTDM, such as age, ethnicity, overweight and obesity and the Immunosuppressant scheme established in the immediate post-transplant period. High doses of tacrolimus and corticosteroid represent the highest risk for developing PTDM. Objectives: This study aimed to evaluate Fasting blood sugar and HbA1c levels among Kidney Allograft recipient patients under Tacrolimus treatment, and to correlate the relationship between Glucose and Tacrolimus dose and tacrolimus and HBA1c among Kidney Allograft recipient patients. Materials and Methods: This was a descriptive cross sectional hospital-based study, conducted in Ibn Sena hospital for renal care, Khartoum, Sudan from December 2016 to February 2017. It covered total of 100 post renal transplantation patients. This study was approved by ethical committee of the faculty of medical laboratory sciences, Alneelain University, and informed consent was obtained from each participant before sample collection and ethical conduct was maintained during data collection and throughout the research process. All statistical analyses were performed by SPSS software version (20). Results: Total of 100 post-renal transplantation patients were evaluated in this study, mean age of cases was 39 years and the majority of them were males. The results showed increasing in FBG above than normal ranges and HbA1c in upper limit associated with increasing duration of transplantation more than one year among patient. whom used to take Tacrolimus more than one year, this relationships were strongly significant. In addition, the results were clearly appeared among females more than males and associated with advancing in age. This findings were associated with patients who use Medrol associated with Tacrolimus, while patients whom use Delatasone or Oraped shows normal FBG and HbA1c level. According to the results above, the probability of gaining diabetes mellitus is increased among renal transplantation cases whom used to take Medrol more than one year. Conclusion: Tacrolimus-based immunosuppression post renal transplantation has a strongly effect on increasing FBG and HbA1c levels and this may lead to gain diabetes mellitus. In addition, using Medrol associated with Tacrolimus increase the risk of elevating FBG and HbA1c levels.

Keywords: post-renal transplantation, Tacrolimus, Diabetes mellitus.