Low vitamin D exposure is associated with higher risk of infection in renal transplant recipients

Kalluri, Hari V.; Sacha, Lauren M.; Ingemi, Amanda I.; Shullo, M.; Johnson, Heather; Sood, Puneet; Tevar, Amit D.; Humar, Abhinav; Venkataramanan, Raman

doi:10.1111/ctr.12955

Cited by 16 publications

(16 citation statements)

References 15 publications

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“…Biological plausibility was supported by the dose‐response gradient observed between lower quartiles of serum 25(OH)D levels and infection susceptibility, with a 24% decrease in the risk of overall infection per each one‐quartile increase. Our results reinforce recent studies suggesting the clinical relevance of the immunomodulatory role attributable to vitamin D in the setting of ongoing immunosuppression after KT.…”

Section: Discussionsupporting

confidence: 90%

“…In contrast to our study, serum 25(OH)D levels were drawn at random intervals rather than at pre‐established time points after transplantation. Moreover, more than half of patients lacked vitamin D measurement . Finally, Moscarelli et al measured 1,25(OH) 2 D 3 (calcitriol) at post‐transplant months 1, 6 and 12 and observed a significant association between serum levels <20 pg/mL and the development of CMV or BK viremia.…”

Section: Discussionmentioning

confidence: 99%

“…Vitamin D deficiency is common among patients with ESRD, and such status may persist after KT . Recent studies have reported an increased risk of infection for vitamin D‐deficient KT recipients . However, many of these studies only assessed baseline vitamin D levels .…”

Section: Introductionmentioning

confidence: 99%

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Vitamin D deficiency and infection risk in kidney transplant recipients: A single‐center cohort study

Fernández‐Ruiz

Corbella

Morales-Cartagena

et al. 2018

Transplant Infectious Dis

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

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Vitamin D deficiency and infection risk in kidney transplant recipients: A single‐center cohort study

Fernández‐Ruiz

Corbella

Morales-Cartagena

et al. 2018

Transplant Infectious Dis

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“…Notably, also in an additional analysis of opportunistic infections, we could not detect an association with vitamin D status (Table S1). These findings are in line with the results of Ban Th et al Few studies, most of them based on retrospective data collection, reported an association between vitamin D deficiency and infections . The cutoff value used for definition of vitamin D deficiency in our study is based on studies that considered dynamics in bone turnover variables .…”

Section: Discussionsupporting

confidence: 92%

“…In the general population, deficiency of vitamin D has been associated with a higher risk of infections . Among kidney transplant recipients, some studies indicate a relevance of 25‐OHD levels for infections overall, bacterial infections, urinary tract infections, and opportunistic viral infections . Other studies could not identify an association between vitamin D status and infections after kidney transplantation .…”

Section: Introductionmentioning

confidence: 99%

Vitamin D deficiency is common in kidney transplant recipients, but is not associated with infections after transplantation

Schreiber

Kusejko

Bischoff‐Ferrari³

et al. 2020

Clinical Transplantation

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The relevance of vitamin D for infections after kidney transplantation is poorly defined. 25‐OH vitamin D (25‐OHD) levels of 135 kidney transplant recipients, enrolled in the Swiss Transplant Cohort Study, were determined peri‐transplant and 6 months post‐transplant. Logistic regression was used to address the associations of 25‐OHD and overall infections and bacterial infections, respectively. For the first 6 months post‐transplant, 25‐OHD peri‐transplant, and for the second period (after 6 to 30 months post‐transplant), 25‐OHD at 6 months post‐transplant was considered. Vitamin D deficiency was common peri‐transplant and remained highly prevalent 6 months after transplantation despite frequent supplementation. Median 25‐OHD levels increased from 12.0 ng/mL (IQR 5.3‐19.5) peri‐transplant to 16.5 ng/mL (IQR 10.6‐22.6) 6 months post‐transplant (P = .005). We did not detect a significant association between 25‐OHD and overall infections (adjusted odds ratio (aOR) 1.05, 95% confidence interval (95%CI) 0.44‐2.51; aOR 0.67, 95%CI 0.31‐1.43) or bacterial infections (aOR 0.79, 95%CI 0.32‐1.96; aOR 0.79, 95%CI 0.35‐1.75) for the first and second period. To conclude, at both time points, vitamin D deficiency was observed in more than 50% of kidney recipients, albeit an increase in 25‐OHD in the longitudinal course was observed. No significant association between 25‐OHD and infections was detected.

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General Approach to the Clinical Care of Solid Organ Transplant Recipients with COVID-19 Infection

2020

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Purpose of Review Insufficient knowledge about COVID-19 and the potential risks of COVID-19 are limiting organ transplantation in wait-listed candidates and deferring essential health care in solid organ transplant recipients. In this review, we expand the understanding and present an overview of the optimized management of COVID-19 in solid organ transplant recipients. Recent Findings Transplant recipients are at an increased risk of severe COVID-19. The unique characteristics of transplant recipients can make it more difficult to identify COVID-19 . Based on the COVID-19 data to date and our experience, we present testing, management, and prevention methods for COVID-19. Comprehensive diagnostic tests should be performed to determine disease severity, phase of illness, and identify other comorbidities in transplant recipients diagnosed with COVID-19. Outpatients should receive education for preventative measures and optimal health care delivery minimizing potential infectious exposures. Multidisciplinary interventions should be provided to hospitalized transplant recipients for COVID-19 because of the complexity of caring for transplant recipients. Summary Transplant recipients should strictly adhere to infection prevention measures. Understanding of the transplant specific pathophysiology and development of effective treatment strategies for COVID-19 should be prioritized.

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Low vitamin D exposure is associated with higher risk of infection in renal transplant recipients

Abstract: Adequate levels of vitamin D in kidney transplant recipients are associated with lower infection risk in the first year and at any time post-transplantation.

Cited by 16 publications

References 15 publications

Vitamin D deficiency and infection risk in kidney transplant recipients: A single‐center cohort study

Vitamin D deficiency and infection risk in kidney transplant recipients: A single‐center cohort study

Vitamin D deficiency is common in kidney transplant recipients, but is not associated with infections after transplantation

General Approach to the Clinical Care of Solid Organ Transplant Recipients with COVID-19 Infection

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