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 occurs in more than 80% of kidney transplant recipients. Its immunomodulatory effects can predispose transplant recipients to rejection and chronic allograft nephropathy (CAN). This study determined the association be
To determine the relationship between serum 25 (OH) vitamin D level and bio
Adult renal transplant recipients followed at the clinic between January 2013 and 2018 were included. Recipients requiring graft biopsy due to declined function, hematuria, and proteinuria were reviewed. The two groups were compared re
Fifty-two recipients who underwent graft biopsy met the inclusion criteria. In all, 14 recipients had a vitamin D level > 15 ng/mL (group 1) vs ≤ 15 ng/mL (group 2) in 38. In total, 27 patients had biopsy-proven rejection, and 19 had CAN. There was only 1 recipient with biopsy-proven rejection in group 1, whereas there were 24 patients with rejection in group 2. The rejection rate was significantly higher in group 2 than in group 1 (P < 0.001). Four patients were diagnosed with CAN in group 1 vs fifteen in group 2. There was no significant difference in the CAN rate between the two groups. PTH was higher at the time of graft biopsy (P = 0.009, P = 0.022) in group 1 with a mean of 268 pg/mL. Donor-specific antibodies were detected in 14 (56.0%) of the re
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 determine the effect of serum vitamin D levels on allograft rejection.
Core Tip: This study analyzed the results of 130 kidney transplant recipients. Of the 52 recipients who underwent graft biopsy and met the study inclusion criteria, 14 had a vitamin D level > 15 ng/mL vs ≤ 15 ng/mL in 38. Although low serum vitamin D level emerged as a risk factor for rejection in univariate analysis, this finding was not confirmed by multivariate analysis. Nonetheless, diagnostic and predictive accuracy is limited when a single test is used, and larger-scale prospective clinical studies are needed to clearly discern the effects of serum vitamin D level on the renal allograft rejection rate.