Published online Sep 18, 2022. doi: 10.5500/wjt.v12.i9.299
Peer-review started: April 29, 2022
First decision: May 12, 2022
Revised: June 1, 2022
Accepted: September 8, 2022
Article in press: September 8, 2022
Published online: September 18, 2022
Vitamin D deficiency is commonly diagnosed in patients with kidney transplantation. Deficiency rate remains high despite replacement therapies as per the Kidney Disease Improving Global Outcomes guidelines.
Vitamin D has immunomodulatory effects and vitamin D receptors can be found in various types of cells including T cells and dendritic cells. Its deficiency may predispose transplant recipients to rejection and chronic allograft nephropathy (CAN).
This study determined the association between the serum 25 (OH) vitamin D, biopsy-proven allograft rejection, and CAN rates.
Retrospective clinical study involving adult kidney transplant recipients requiring graft biopsy due to declined function, hematuria, and proteinuria.
Vitamin D level was 9.7 ± 3.4 ng/mL in the rejection group vs 14.7 ± 7.2 in the non-rejection group; this difference was statistically significant (P = 0.003). In univariate regression analysis of risk factors affecting rejection, sex, serum vitamin D, phosphorus and albumin were found to have impact (P = 0.027, P = 0.007, P = 0.023, P = 0.008). In multivariate regression analysis, the same factors did not affect rejection.
The serum 25 (OH) vitamin D level in kidney transplant recipients remained low. Although low serum vitamin D level emerged as a risk factor for rejection in univariate analysis, this finding was not confirmed by multivariate analysis. Prospective studies are required to appreciate the effect of serum vitamin D levels on allograft rejection.
Kidney transplantation is the best treatment option for patients with terminal kidney failure. Successful transplantation prolongs longevity and significantly improves the quality of life. However, the long term success of kidney transplantation depends on preventing the chronic allograft dysfunction. Chr