Epidemiology of new-onset diabetes mellitus after dialysis

Introduction Diabetic nephropathy is the leading cause of end-stage renal disease in patients undergoing dialysis. Most studies evaluate the association between pre-existing diabetes mellitus, but very few focus on newonset diabetes mellitus after dialysis. Chronic dialysis patients are often older and have multiple comorbidities, including cardiovascular diseases and pancreatic disorder. In addition, these patients have been found to be in a state of chronic inflammation. These characteristics have been associated with the development of insulin resistance and diabetes. Herein, we critically review the epidemiology, risk factors and mortality of new-onset diabetes mellitus after dialysis. Conclusion The dialysis population has a higher incidence of new-onset diabetes mellitus and a greater risk of mortality than the general population. In addition, the post-transplant incidence of diabetes mellitus, which always occurs the first year after transplant, is much higher than the pre- transplant incidence. However, dialysis modality does not appear to be associated with new-onset diabetes mellitus after dialysis and post- transplant. The independent predictors of newonset diabetes mellitus are old age, cardiovascular comorbidity and dyslipidemia. Other possible contributing factors are inflammation and use of some commonly prescribed drugs for cardiovascular disease, such as statin. Physicians may need to pay more attention to the possibility of new-onset diabetes mellitus when treating high-risk patients undergoing dialysis.