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Background: New‐onset diabetes after transplantation refers to the development of diabetes after solid organ transplantation without a history of diabetes and is related to poor graft function and lower survival rate. In the kidney transplant population, NODAT occurs in 24% of adults and 9% of children. The real incidence and risk factors in the pediatric population is unknown, which we aimed to determine in this study. Methods: A retrospective study was conducted in patients who underwent kidney transplantation in the Pediatric Nephrology Service of the "Federico Gómez" Children's Hospital of Mexico. Results: The study included 127 children divided into groups 1 and 2 (without [n = 110 patients, 86.5%] and with NODAT [n = 17 patients, 13.4%], respectively), with median ages of 14 years (interquartile range [IQR], 9–16 years) and 15 years (IQR, 13–16 years; p =.3), respectively. Cox proportional hazards analysis revealed an association between changes from baseline to 24‐h postoperative blood glucose level as a risk factor of the development of NODAT. This implies that each unit increase in blood glucose level in the first hours after transplantation also increases the risk of developing diabetes (95% confidence interval, 1.011–1.021; p = <.001). Conclusions: Post‐kidney transplant patients require immediate follow‐up, and attention should be paid to changes in blood glucose level in the first 24 h after transplantation, as any alteration may be an early sign of development of NODAT, especially in patients with a family history of diabetes mellitus. [ABSTRACT FROM AUTHOR]

Background: In recent years, chronic kidney disease has increased in the pediatric population and has been related to environmental factors. In the diagnosis of kidney damage, in addition to the traditional parameters, early kidney damage biomarkers, such as kidney injury molecule 1, cystatin C, and osteopontin, among others, have been implemented as predictors of early pathological processes., Objective: This study aimed to evaluate the relationship between exposure to environmental pollutants and early kidney damage biomarkers., Methods: A cross-sectional pilot study was conducted in February 2016 and involved 115 apparently healthy children aged 6-15 residing in Apizaco, Tlaxcala. Participant selection was carried out randomly from among 16,472 children from the municipality of Apizaco. A socio-demographic questionnaire included  age, sex, education, duration of residence in the area, occupation, water consumption and dietary habits, pathological history, and some non-specific symptoms. Physical examination included blood pressure, weight, and height. The urine concentrations of urinary aluminum, total arsenic, boron, calcium, chromium, copper, mercury, potassium, sodium, magnesium, manganese, molybdenum, lead, selenium, silicon, thallium, vanadium, uranium, and zinc, were measured. Four of the 115 participants selected for the study were excluded due to an incomplete questionnaire or lack of a medical examination, leaving a final sample population of 111 participants., Results: The results showed a mean estimated glomerular filtration rate of 89.1 ± 9.98 mL/min/1.73m 2 and a mean albumin/creatinine ratio of 12.9 ± 16.7 mg/g urinary creatinine. We observed a positive and significant correlation between estimated glomerular filtration rate with fluoride, total arsenic and lead, and a correlation of albumin/creatinine ratio with fluoride, vanadium, and total arsenic. There was also a significant correlation between the early kidney damage biomarkers and fluoride, vanadium, and total arsenic, except for cystatin C., Conclusion: In conclusion, our results show that four urinary biomarkers: α1-microglobulin, cystatin C, kidney injury molecule 1, and neutrophil gelatinase-associated lipocalin are related to environmental exposure to urinary fluoride, vanadium, and total arsenic in our pediatric population., (© 2023. The Author(s) under exclusive licence to Italian Society of Nephrology.)

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