Vitamin D and subclinical cardiac damage in a cohort of kidney transplanted patients: a retrospective observational study

Abstract

In 178-kidney transplanted patients (KTxp), the prevalence of hypovitaminosis-D, the presence and novel development of left ventricular hypertrophy(LVH) and the correlations between native Vitamin-D (25OHD) and LVH were evaluated during the 1st year of transplantation (KTx). Clinical and instrumental data were recorded at pre-KTx and at one (T1) and 12 (T12) months after KTx. 25OHD levels were considered sufficient (s25OHD, ≥ 30 ng/dL) or insufficient (i25OHD, < 30 ng/dL). 25OHD correlated at T1 with parathormone(PTH), and at T12 with 25OHD-T1 and PTH-(T1,T12). At T12, s25OHD (15%) had higher 25OH and alkaline phosphatase (ALP), lower Ca, at T1, and lower PTH-(T1, T12) than i25OH-T12. At T1, KTxp with LVH (LVH-T1pos, 42%) were older and with longer dialysis vintage than LVH-T1neg. At T12, KTxp with LVH (LVH-T12pos, 53%) were older, with higher systolic blood pressure (SBP) at T12 than LVH-T12neg. No relation between 25OHD and LVH were found. Novel LVH was found in 14% of KTxp. They were older, had higher SBP-T12 and lower serum albumin-T12 than the others. LVH-modifications and 25OHD were not correlated. Hypovitaminosis-D is highly prevalent in KTxp. LVH correlates with different risk factors according to the time elapsed from KTx. However, during the 1st year of KTx, no relationship between LVH and 25OHD was observed.

Endocan and Circulating Progenitor Cells in Women with Systemic Sclerosis: Association with Inflammation and Pulmonary Hypertension

“…These in vitro studies suggest a potential therapeutic role for vitamin D in enhancing the endothelial integrity under the circumstances involving vascular injury through the improvement of EPCs features. Although a number of epidemiological data indicate an association between vitamin D deficiency and CVD, suggesting a potential protective role, and experimental studies seem to support the anti-fibrotic and anti-hypertrophic role of vitamin D [ 76 ], the interventional studies with calcitriol or VDR agonists only in part support these beneficial effects; indeed, vitamin D treatment promote left ventricular reverse remodeling, as indicated by the reduction in ventricle volumes and improved function, and also improve survival in advanced CVD or CKD, but further randomized trials are expected to confirm whether supplementation of vitamin D may significantly influence the outcomes [ 77 , 78 , 79 , 80 ], apart from the difficulties already underlined in designing specific RCTs [ 81 ]. Although SSc patients selected for our study were already treated with a standard cholecalciferol 25.000 U per month, one-third out of them presented with vitamin D levels < 20 ng/mL.…”