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

Hyunwook Kim, Shin-Wook Kang, Tae-Hyun Yoo, Myoung Soo Kim, Soon Il Kim, Yu Seun Kim and Kyu Hun Choi
BMC Nephrology 2012, 13:22 doi:10.1186/1471-2369-13-22; Published: 25 April 2012

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 followup 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.
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Wonder:

1. If anyone has considered the vitamin D level of the organ being transplanted
2. If increasing the levels of vitamin D might delay or eliminate the need for some transplants
3. How many of the kidney rejections had extremely low level of vitamin D (rejects were not considered in the study)
4. What could have be learned if they had measured the vitamin D levels at the end of the study
5. What would the statistics have looked like if they had not thrown out the results of those taking vitamin D supplements

PDF is attached at the bottom of this page

See also Vitamin D Life

• Overview Kidney and vitamin D
• Kidney transplant patients advised to avoid the sun, then 90% have very low vitamin D levels – Sept 2012
• Heart transplant 19 ng vitamin D vs liver transplant 13 ng – April 2009
• Vitamin D levels low both before and after organ transplant July 2011
• Babies Receive Heart Transplants Instead of Vitamin D Treatment
• All items in category After Surgery or Trauma 278 items
• If you are getting a lung transplant you must have vitamin D - April 2012

Clinical Trials: Transplant and Vitamin D 36 listed as of Jan 2013