Vitamin D Deficiency in a Renal Transplant Population: Safe Repletion With Moderate Doses of Calcidiol

Berga, J. Kanter; Albiach, J. Crespo; Catalán, Sandra Beltrán; Martínez, Eva Gavela; Calabuig, Asunción Sancho; Bernabeu, A. Ávila; Mateu, L.M. Pallardó

doi:10.1016/j.transproceed.2010.08.015

Cited by 15 publications

(7 citation statements)

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“…, who also studied de novo transplant recipients irrespective of PTH‐levels, not finding a persistent anti‐proteinuric effect. In another study of 110 renal transplant recipients with vitamin D levels in the lower range, oral calcidiol did not reduce proteinuria . The complexity of what may occur to renal allografts during the early phase after transplant, combined with very modest baseline levels of albuminuria is likely to mask potential anti‐proteinuric effects of VDRA treatment in de novo allograft recipients.…”

Section: Discussionmentioning

confidence: 99%

Early introduction of oral paricalcitol in renal transplant recipients. An open-label randomized study

et al. 2017

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In stable renal transplant recipients with hyperparathyroidism, previous studies have indicated that vitamin D agonist treatment might have anti-proteinuric effects. Animal studies indicate possible anti-fibrotic and anti-inflammatory effects. Early introduction of paricalcitol in de novo renal transplant recipients might reduce proteinuria and prevent progressive allograft fibrosis. We performed a single-center, prospective, randomized, open-label trial investigating effects of paricalcitol 2 μg/day added to standard care. Participants were included 8 weeks after engraftment and followed for 44 weeks. Primary end point was change in spot urine albumin/creatinine ratio. Exploratory microarray analyses of kidney biopsies at study end investigated potential effects on gene expression. Secondary end points included change in glomerular filtration rate (GFR), pulse wave velocity (PWV), and endothelial function measured by peripheral arterial tonometry as reactive hyperemia index (RHI). Seventy-seven de novo transplanted kidney allograft recipients were included, 37 receiving paricalcitol. Paricalcitol treatment lowered PTH levels (P = 0.01) but did not significantly reduce albuminuria (P = 0.76), change vascular parameters (PWV; P = 0.98, RHI; P = 0.33), or influence GFR (P = 0.57). Allograft gene expression was not influenced. To summarize, in newly transplanted renal allograft recipients, paricalcitol reduced PTH and was well tolerated without negatively affecting kidney function. Paricalcitol did not significantly reduce/prevent albuminuria, improve parameters of vascular health, or influence allograft gene expression.

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Section: Discussionmentioning

confidence: 99%

Early introduction of oral paricalcitol in renal transplant recipients. An open-label randomized study

et al. 2017

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“…In previous studies, the prevalence of vitamin D deficiency among KTRs was reported as 38.7% to 61.5% [12,14,20-22]. However, because the definition of vitamin D deficiency varied among studies, the precise prevalence of vitamin D deficiency in KTRs is unclear.…”

Section: Discussionmentioning

confidence: 99%

Vitamin D deficiency is associated with increased risk of bacterial infections after kidney transplantation

Park

Kim

Lee

et al. 2017

Korean J Intern Med

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Background/AimsThere may be an association between vitamin D levels and allograft outcomes in kidney transplant recipients (KTRs). However, few studies have been conducted to determine the association between vitamin D levels and post-transplant infections. This study investigated the impact of vitamin D deficiency on the risk of infection after kidney transplantation.MethodsWe measured 25-hydroxyvitamin D (25(OH)D) levels prior to kidney transplantation. Vitamin D deficiency was defined as a serum 25(OH)D level < 20 ng/mL. We examined the incidence of various post-transplant infections during follow-up period. We used Cox proportional hazards regression analysis to determine factors associated with increased risk of post-transplant infections during the follow-up period.ResultsA total of 164 KTRs were followed up for a mean of 24.8 ± 10.7 months. Among them, 135 patients (82.3%) had vitamin D deficiency. Patients with vitamin D deficiency had a significantly higher incidence of urinary tract infection (p = 0.027) and any bacterial infection (p = 0.010) compared to those without vitamin D deficiency. Vitamin D deficiency was not significantly associated with incidence of viral or fungal infections. Cox proportional hazards regression analysis revealed that vitamin D deficiency (hazard ratio, 11.07; 95% confidence interval, 1.46 to 84.03; p = 0.020) was independent risk factor for post-transplant bacterial infections.ConclusionsPre-transplant vitamin D deficiency was a significant risk factor for bacterial infections after kidney transplantation. Further studies are needed on possible benefits of vitamin D supplementation for preventing post-transplant bacterial infection.

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“…The characteristics of the studies selected for this systematic review and meta-analysis are detailed in Table 1 . The study design was cross-sectional in 27 studies [ 11 , 12 , 14 , 15 , 18 – 21 , 23 – 32 , 34 – 37 , 41 – 45 ] (71.1%) and longitudinal in 11 [ 13 , 16 , 17 , 22 , 33 , 38 – 40 , 46 – 48 ] (28.9%). All these articles were published between 2001 and 2021, and most of them were conducted in Europe [ 13 , 14 , 16 , 19 – 24 , 29 – 31 , 35 , 36 , 38 , 39 , 42 ] (44.7%), although there were also studies from Asia [ 11 , 18 , 25 – 27 , 34 , 37 , 40 , 43 , 45 , 46 , 48 ] (31.6%), America [ 15 , 17 , 28 , 32 , 33 , 44 , 47 ] (18.4%) and Oceania [ 12 , 41 ] (5.3%).…”

Section: Resultsmentioning

confidence: 99%

Prevalence of Musculoskeletal and Metabolic Disorders in Kidney Transplant Recipients: A Systematic Review and Meta-Analysis

Herreros-Carretero,

Berlanga-Macías,

Martínez-Vizcaíno

et al. 2024

Transpl Int

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Introduction:Musculoskeletal disorders could be associated with metabolic disorders that are common after kidney transplantation, which could reduce the quality of life of patients. The aim of this study was to assess the prevalence of both musculoskeletal and metabolic disorders in kidney transplant patients.Methods:MEDLINE, CINAHL, Cochrane Library, EMBASE and Web of Science were searched from their inception up to June 2023. DerSimonian and Laird random-effects method was used to calculate pooled prevalence estimates and their 95% confidence intervals (CIs).Results:21,879 kidney transplant recipients from 38 studies were analysed. The overall proportion of kidney transplant patients with musculoskeletal disorders was 27.2% (95% CI: 18.4–36.0), with low muscle strength (64.5%; 95% CI: 43.1–81.3) being the most common disorder. Otherwise, the overall proportion of kidney transplant patients with metabolic disorders was 37.6% (95% CI: 21.9–53.2), with hypovitaminosis D (81.8%; 95% CI: 67.2–90.8) being the most prevalent disorder.Conclusion:The most common musculoskeletal disorders were low muscle strength, femoral osteopenia, and low muscle mass. Hypovitaminosis D, hyperparathyroidism, and hyperuricemia were also the most common metabolic disorders. These disorders could be associated with poorer quality of life in kidney transplant recipients.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/, identifier [CRD42023449171].

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Vitamin D Deficiency in a Renal Transplant Population: Safe Repletion With Moderate Doses of Calcidiol

Cited by 15 publications

References 14 publications

Early introduction of oral paricalcitol in renal transplant recipients. An open-label randomized study

Early introduction of oral paricalcitol in renal transplant recipients. An open-label randomized study

Vitamin D deficiency is associated with increased risk of bacterial infections after kidney transplantation

Prevalence of Musculoskeletal and Metabolic Disorders in Kidney Transplant Recipients: A Systematic Review and Meta-Analysis

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