Vitamin D status, bone mineral density, and inflammation in kidney transplantation patients.
Vitamin D has immunomodulatory and anti-inflammatory activities in the healthy population and in various disease states. There are few data on the quantification of vitamin D status and inflammation with respect to changes in bone mineral density among renal transplantation patients. We analyzed the influence of vitamin D levels on allograft function and inflammatory status at the time of enrollment and at 1-year follow-up. Sixty-four renal transplant patients, including 38 males, showed an overall age of 38.61 +/- 1.05 years, had a mean graft age of 6.15 +/- 3.17 years. We excluded patients who had diabetes mellitus, chronic inflammatory disease, or chronic allograft nephropathy. We obtained pre- and posttransplantation serum samples and daily proteinuria on each patient. Measurements of bone mineral density were performed by dual-energy X-ray absortiometry. After enrollment, we followed the patients for 1 year. Thereafter we assessed serum creatinine, C-reactive protein, albumin, and spot urinary protein levels. The patients were divided into two groups based upon vitamin D levels: group I (n = 29), <20 microg/L versus group II (n = 35), >or=20 microg/L. There was no significant difference in intact parathyroid hormone levels between the two groups. Vitamin D level positively correlated with serum creatinine (r = .32, P = .01) and serum albumin levels (r = .28, P = .023) at the time of enrollment. At 1 year, patients in group I showed significantly higher creatinine (P < .001) and proteinuria levels (P < .05) than those in group II. Low vitamin D levels are not uncommon among renal transplant recipients. There was a significant association of vitamin D levels with renal allograft function. Low vitamin D levels may be a predictor of worsening of graft function and increasing proteinuria.
Sezer
S
S
Department of Nephrology, Baskent University Faculty of Medicine, Ankara, Turkey.
Yavuz
D
D
Canoz
M B
MB
Ozdemir
F N
FN
Haberal
M
M
D000328:Adult; D001794:Blood Pressure; D015519:Bone Density; D002097:C-Reactive Protein / Q000378:metabolism; D003404:Creatinine / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006650:Histocompatibility Testing; D006801:Humans; D007249:Inflammation / Q000453:epidemiology*; D016030:Kidney Transplantation / Q000009:adverse effects / Q000276:immunology / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D011507:Proteinuria; D012709:Serum Albumin / Q000378:metabolism; D014807:Vitamin D / Q000097:blood*
D012709:Serum Albumin; D014807:Vitamin D; D002097:C-Reactive Protein; D003404:Creatinine