DIABETES AS A COMPLICATION OF TACROLIMUS (FK506) IN PEDIATRIC RENAL-TRANSPLANT PATIENTS

Three cases of insulin-requiring diabetes mellitus associated with tac rolimus (FK506) therapy in pediatric renal transplant patients are pre sented. New-onset diabetes mellitus has been reported with tacrolimus therapy post liver and kidney transplants in up to 12% of adult patien ts, but is thought to be rare in pediatrics. Although insulin requirem ent with tacrolimus therapy has been occasionally reported in adolesce nt patients post liver transplant, only a single case in a pediatric k idney transplant recipient has been previously documented. These cases illustrate the significant diabetogenic effect of tacrolimus in pedia tric renal transplant patients. As the use of tacrolimus becomes more prevalent in pediatric kidney transplantation, pediatric nephrologists should be aware of this potential complication.