25-hydroxyvitamin D deficiency and opportunistic viral infections after kidney transplant.
OBJECTIVE
Vitamin D may modulate immune function. The purpose of this study was to evaluate the association of 25-hydroxyvitamin D level at kidney transplant with outcomes after transplant, including opportunistic viral infections (cytomegalovirus infection and BK viremia), acute allograft rejection, and delayed graft function.


METHODS
A retrospective review was performed in kidney transplant recipients who had 25-hydroxyvitamin D levels drawn within 30 days before or after of transplant from January 2004 to May 2009 at Henry Ford Hospital and who were followed for 1 year after transplant.


RESULTS
There were 89 patients included in the study (mean age, 51 ± 14 y; male, 66%; African American, 49%; living-donor transplant, 26%). There was a significantly lower frequency of opportunistic viral infections in the vitamin D sufficient group (3 patients, 12%) than vitamin D insufficient group (24 patients, 38%; P ≤ .01). Multivariate analysis showed that male sex and vitamin D insufficiency were independently associated with increased incidence of opportunistic viral infection.


CONCLUSIONS
In kidney transplant recipients, male sex and vitamin D insufficiency are independently associated with increased incidence of opportunistic viral infection. The risk of developing opportunistic viral infections after kidney transplant may be modified by ensuring adequate 25-hydroxyvitamin D levels before transplant.
Department of Pharmacy Services, Henry Ford Hospital, Detroit, MI, USA.
Megan A
MA
Rech
James N
JN
Fleming
Carol L
CL
Moore
D000328:Adult; D000368:Aged; D001739:BK Virus / Q000276:immunology / Q000472:pathogenicity*; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D003586:Cytomegalovirus Infections / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology / Q000821:virology*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D015994:Incidence; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008824:Michigan / Q000453:epidemiology; D008875:Middle Aged; D015999:Multivariate Analysis; D009894:Opportunistic Infections / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology / Q000821:virology*; D027601:Polyomavirus Infections / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology / Q000821:virology*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D016896:Treatment Outcome; D014412:Tumor Virus Infections / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology / Q000821:virology*; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology
D015415:Biomarkers; D007166:Immunosuppressive Agents; D014807:Vitamin D; C104450:25-hydroxyvitamin D