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Diagnostic accuracy of glycated hemoglobin for post-transplantation diabetes mellitus after kidney transplantation: systematic review and meta-analysis.
Pimentel, Ana Laura; Cavagnolli, Gabriela; Camargo, Joíza Lins.
Afiliação
  • Pimentel AL; Graduate Programme in Endocrinology, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
  • Cavagnolli G; Graduate Programme in Endocrinology, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
  • Camargo JL; Centro Universitário FSG, Caxias do Sul, Brazil.
Nephrol Dial Transplant ; 32(3): 565-572, 2017 03 01.
Article em En | MEDLINE | ID: mdl-28088775
Background: Early detection of post-transplantation diabetes mellitus (PTDM) allows prompt clinical and pharmacological interventions, reducing the chance of adverse outcomes. We conducted a systematic review and meta-analysis to determine the overall diagnostic accuracy of glycated hemoglobin (HbA1c) for the diagnosis of renal PTDM. Methods: We searched MEDLINE, Embase and SCOPUS up to June 2016. Studies that included adults without previous diabetes were selected if they reported an oral glucose tolerance test as a reference test, HbA1c levels measured by standardized methods and data necessary for drawing 2 × 2 tables. A bivariate model was used to calculate the pooled estimates. Results: Based on 2057 kidney recipients from six studies, an HbA1c cut-off point of 6.5% in early months after transplant resulted in sensitivity of 0.48 [95% confidence interval (95% CI) 0.31-0.65], specificity of 0.96 (95% CI 0.95-0.97), positive likelihood ratio (PLR) of 12.0 (95% CI 7.4-19.5) and negative likelihood ratio (NLR) of 0.54 (95% CI 0.38-0.77). Based on 1888 kidney recipients from four studies, an HbA1c cut-off point of 6.2% early after transplant resulted in sensitivity of 0.76 (95% CI 0.49-0.91), specificity of 0.89 (95% CI 0.86-0.92), PLR of 7.18 (95% CI 5.29-9.75) and NLR of 0.27 (95% CI 0.11-0.65). Conclusion: HbA1c cut-off points of 6.5% and 6.2% presented high specificity but low/moderate sensitivity to diagnose PTDM.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Complicações Pós-Operatórias / Hemoglobinas Glicadas / Transplante de Rim / Diabetes Mellitus Tipo de estudo: Diagnostic_studies / Prognostic_studies / Screening_studies / Systematic_reviews Limite: Humans Idioma: En Revista: Nephrol Dial Transplant Assunto da revista: NEFROLOGIA / TRANSPLANTE Ano de publicação: 2017 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Complicações Pós-Operatórias / Hemoglobinas Glicadas / Transplante de Rim / Diabetes Mellitus Tipo de estudo: Diagnostic_studies / Prognostic_studies / Screening_studies / Systematic_reviews Limite: Humans Idioma: En Revista: Nephrol Dial Transplant Assunto da revista: NEFROLOGIA / TRANSPLANTE Ano de publicação: 2017 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido