Kidney Graft Loss Risk Not Associated With Vitamin D Deficiency

NEW ORLEANS—Kidney transplant recipients with low 25-hydroxyvitamin D (25-OHD) levels are at no greater risk for allograft function decline, according to a new study presented at the American Society of Nephrology’s Kidney Week 2017.

Puneet Bedi, MD, and colleagues from Montefiore Medical Center in Bronx, New York, measured 25-OHD levels and intact-parathyroid hormone (iPTH) levels after kidney transplantation in 383 patients.

At 6 months after transplantation, 29.2% and 22.2% of patients had 25-OHD levels below 15 and 15 to 19.9 ng/mL, respectively. At 1 year, the proportions were 14.9% and 21.9%, respectively, and at 3 years 16.8% and 18.5%. When patients were stratified by vitamin D status, the groups appeared similar in age, sex, race, type of transplant, donor age, donor final creatinine, kidney donor profile index (KDPI) score, panel reactive antibody, pre-transplant donor-specific antibodies, and type of induction therapy. Higher iPTH levels correlated with lower 25-OHD values at 6 months.

Lower 25-OHD levels were not associated with an increased risk for graft loss. Other outcomes were similar as well regardless of vitamin D status over 3 years of follow-up, including patient survival, acute antibody or T-cell mediated rejection, transplant glomerulopathy, de novo donor-specific antibodies, opportunistic viral (cytomegalovirus and BK virus) and fungal infections, malignancy, proteinuria, and serum creatinine levels.

“Vitamin D deficiency after kidney transplantation is common. However, our single center retrospective study did not demonstrate any association between low vitamin D levels and any clinical outcomes after kidney transplantation including acute and chronic rejection, allograft function, proteinuria, opportunistic infections and malignancy,” co-investigator Enver Akalin, MD, told Renal & Urology News. “To reach more meaningful conclusions, multicenter and prospective trials are required.”

Reference

Bedi P, Hayde NA, Ajaimy M, Akalin E. Prevalence of vitamin D deficiency after kidney transplantation and its association with clinical outcomes . Presented in poster format at Kidney Week 2017 in New Orleans (Oct. 31-Nov. 5). Poster TH-PO925.