Hypomagnesemia and increased risk of new-onset diabetes mellitus after transplantation in pediatric renal transplant recipients

Background: New onset diabetes after transplantation (NODAT) is a significant co-morbidity following kidney transplantation. Lower post-transplant serum magnesium levels have been found to be an independent risk factor for NODAT in adult kidney transplant recipients. / Methods: We undertook a retrospective analysis of risk factors for NODAT in pediatric renal transplant recipients at our institution with the aim of determining if hypomagnesemia confers a significant risk of developing NODAT in children. / Results: One hundred and seventy three children with median age at transplantation 7.0 (range: 1.3 – 17.5) years were included. Hypomagnesemia was a significant independent risk factor for NODAT (p = 0.01). High trough tacrolimus levels were also independently associated with NODAT (p < 0.001). There was no significant association between NODAT and children’s BMI at the time of transplantation, monthly cumulative steroid dose or post transplant CMV viremia (p = 0.9, 0.6 and 0.7 respectively). / Conclusions: This study identifies hypomagnesemia as a significant independent risk factor for developing NODAT in pediatric renal transplant recipients. Given the clear association between hypomagnesemia and NODAT in both adults and children following renal transplantation, further studies are merited to clarify the etiology of this association, and to examine the effect of magnesium supplementation on NODAT