Introduction: Pretransplantation workup should examine risk for kidney transplantation (TX) and for the posttransplantation complications. Unnecessary examinations should be avoided to prevent prolonged workup, to alleviate the procedure for patients and healthcare system and to reduce the costs. KDIGO from 2020 does not recommend oral glucose tolerance test (OGTT) as mandatory prior to kidney TX. Diabetes is expected to worsen upon immunosuppressive therapy, rendering infections more common and increasing cardiovascular risk while new onset diabetes after TX (NODAT) is also a common complication.
Aim: To explore the role of OGTT in patients undergoing workup for kidney TX.
Patients and methods: Historical cohort study included 100 adult patients (58 % men, median age 52 years, 47 - 59) that underwent kidney TX consecutively in a single TX center. OGTT was not a mandatory examination within the workup for kidney TX, thus it was not done in all patients.
Results: Diabetes was basic kidney disease in 8 % of 100 eligible patients and for another 3 % diabetes was diagnosed before workup for TX. OGTT was done in 40 of 89 patients, without previously diagnosed diabetes. In 10 of the 40 patients OGTT showed diabetes (25 %) and glucose intolerance in another 13 (32.5 %), Table 1. Five patients with pathological pretransplantation OGTT developed NODAT (12.5 %), while no one with normal OGTT finding.

Conclusion: OGTT revealed diabetes or glucose intolerance in more than half of randomly examined patients prior to kidney TX. Given the simplicity and low cost of the examination, OGTT might be reconsidered to be included in the workup for kidney TX. Glycemia in patients with diabetes or glucose intolerance should be more closely monitored after TX and immunosuppresion tailored accordingly.