Prevalence of Hypovitaminosis D among Renal Transplant Recipients and Its Relation to Graft Interstitial Fibrosis

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Background:Vitamin D deficiency is not uncommon among kidney transplant recipients which may lead bone diseases, graft aging and vascular disease. We aimed to evaluate the prevalence of hypovitaminosis D among renal transplant recipients and its relation to graft interstial fibrosis in graft biopsies. Methods:We recruited 99 renal transplant recipients with recent graft biopsies performed during the period between 2016 and 2017 in the nephrology department, organ transplant center of Kuwait. We excluded 2nd transplants, previous rejecters, extremes of ages (<18,>70years), postmenopausal women, and conditions that interfered with vitamin D metabolism as hepatic disease, gastric bypass, cystic fibrosis; extensive burns and chronic diarrhea. Patients were divided the into two groups: recent transplants (1- year post-transplant, n=50). We measured serum 25(OH) vitamin D, iPTH, albumin, creatinine, calcium, phosphorus, cholesterol and uric acid. Graft biopsies were assessed according to Banff classification 2013. Results:Most of patients (81.8%) had hypovitaminosis D with variable degrees’ deficiency (48.5 % had insufficiency, 24.2 % had mild deficiency, and 9.1 % had severe deficiency).  In our study, both groups were comparable regarding their demographic data except longer dialysis duration and higher number of patients receiving tacrolimus-based therapy in group 1. Vitamin D level was lower in group 1 but did not rank to significance (p>0.05), however, it had significant negative correlation with iPTH and the degree of renal graft interstitial fibrosis and vitamin D deficiency. Conclusion: The prevalence of 25-OH vitamin D deficiency is high post-transplant and it might contribute to the graft interstitial fibrosis.
 

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Zagazig University Medical Journal
Volume 25, Issue 5
September 2019
Pages 748-758

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