The impact of pretransplant 25-hydroxy vitamin D deficiency on subsequent graft function: an observational study

BMC Nephrol. 2012 Jul 10;13:22. doi: 10.1186/1471-2369-13-22.

Abstract

Background: In addition to its canonical role in musculoskeletal health, several reports have demonstrated that serum vitamin D level may influence kidney function. However, the effect of pretransplant serum vitamin D level on subsequent graft function has not been explored. Therefore, this study was undertaken to examine the effect of serum vitamin D level at the time of kidney transplantation (KT) on subsequent graft function.

Methods: We analyzed 106 patients who underwent KT and for whom 25-hydroxy vitamin D (25-OHD) levels were measured during hospitalization prior to transplantation. We measured estimated glomerular filtration rates (eGFR) using the Modification of Diet in Renal Disease (MDRD) formula at baseline and at six-month intervals up to 36 months after KT.

Results: 38.7% of the patients were diagnosed with 25-OHD deficiency defined as less than 10 ng/mL. Recipient gender (female vs. male, odds ratio [OR] 3.30, 95% CI 1.33-8.21, P=0.010), serum albumin level (per 1 mg/dl increase, OR 0.35, 95% CI 0.13-0.98, P=0.047), and predominant renal replacement therapy modality before KT (P<0.001) were found to be independent pretransplant risk factors for 25-OHD deficiency by multivariate logistic regression analysis. Subsequent repeated measures analysis of covariance revealed that 25-OHD level had the only significant main effect on eGFR during the 36-month follow-up period [F (1, 88)=12.07, P=0.001].

Conclusions: Pretransplant 25-OHD deficiency was significantly associated with a lower post-transplant eGFR, suggesting that 25-OHD may play an important role in maintaining graft function after KT.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Analysis of Variance
  • Confidence Intervals
  • Female
  • Glomerular Filtration Rate*
  • Humans
  • Kidney Transplantation / physiology*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Odds Ratio
  • Postoperative Period
  • Preoperative Period
  • Renal Replacement Therapy / adverse effects
  • Republic of Korea
  • Seasons
  • Serum Albumin / metabolism
  • Sex Factors
  • Sunlight
  • Vitamin D / analogs & derivatives*
  • Vitamin D / blood
  • Vitamin D Deficiency / complications*
  • Vitamin D Deficiency / etiology
  • Young Adult

Substances

  • Serum Albumin
  • Vitamin D
  • 25-hydroxyvitamin D