title: The impact of vitamin D deficiency on patients undergoing kidney transplantation: focus on cardiovascular, metabolic, and endocrine outcomes.
abstract: Vitamin D deficiency is common among kidney transplant (KT) recipients because of reduced sunlight exposure, low intake of vitamin D, the immunosuppressive drug regimen administered, and steroid therapy. Glucocorticoids regulate expression of genes coding for enzymes that catabolize vitamin D, further reducing its level in serum. Although vitamin D primarily regulates calcium homeostasis, vitamin D deficiency is associated with the risk of several diseases, such as diabetes mellitus and tuberculosis. Aim of this review is to highlight endocrine and metabolic alterations due to the vitamin D deficiency by evaluating the mechanisms involved in the development of KT-related disease (cardiovascular, bone mineral density, and new-onset diabetes after transplantation). Next, we review evidence to support a link between low vitamin D status and KT-related diseases. Finally, we briefly highlight strategies for restoring vitamin D status in KT patients.
authors.affiliation: Department of General Surgery and Transplantation Unit, San Giovanni di Dio e Ruggi D'Aragona University Hospital, Scuola Medica Salernitana, Salerno, Italy.
authors.forename: Gerardo
authors.initials: G
authors.lastname: Sarno
authors.affiliation: Divisions of Diabetes and Endocrinology, Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Daniele
authors.affiliation: Division of Endocrinology, Department of Clinical and Molecular Sciences, Umberto I Hospital, School of Medicine, Polytechnic University of Marche, Ancona, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Tirabassi
authors.affiliation: Divisions of Diabetes and Endocrinology, Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
authors.forename: Alberto O
authors.initials: AO
authors.lastname: Chavez
authors.affiliation: Faculty of Life and Health Sciences, School of Biomedical Sciences, University of Ulster, Coleraine, BT52 1SA, UK.
authors.forename: Opeolu O
authors.initials: OO
authors.lastname: Ojo
authors.affiliation: Sports Science and Wellness, University Parthenope Naples, Naples, Italy.|Endocrinology and Diabetology, San Giovanni di Dio e Ruggi D'Aragona University Hospital, Scuola Medica Salernitana, Salerno, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Orio
authors.affiliation: Institute for Clinical and Experimental Medicine, Videnska 1958/9, 140 21, Prague, Czech Republic.
authors.forename: Hana
authors.initials: H
authors.lastname: Kahleova
authors.affiliation: Division of Endocrinology, Department of Clinical and Molecular Sciences, Umberto I Hospital, School of Medicine, Polytechnic University of Marche, Ancona, Italy.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Balercia
authors.affiliation: Sunlight, Nutrition, and Health Research Center, San Francisco, CA, USA.
authors.forename: William B
authors.initials: WB
authors.lastname: Grant
authors.affiliation: Department of General Surgery and Transplantation Unit, San Giovanni di Dio e Ruggi D'Aragona University Hospital, Scuola Medica Salernitana, Salerno, Italy.
authors.forename: Paride
authors.initials: P
authors.lastname: De Rosa
authors.affiliation: Department of Clinical Medicine and Surgery, Federico II University Hospital, Federico II University, Naples, Italy.
authors.forename: Annamaria
authors.initials: A
authors.lastname: Colao
authors.affiliation: Department of Clinical Medicine and Surgery, Federico II University Hospital, Federico II University, Naples, Italy. giovanna.muscogiuri@gmail.com.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Muscogiuri
mesh_terms: D015519:Bone Density; D002318:Cardiovascular Diseases / Q000209:etiology; D003920:Diabetes Mellitus / Q000209:etiology; D006801:Humans; D016030:Kidney Transplantation; D011183:Postoperative Complications / Q000209:etiology*; D014807:Vitamin D / Q000008:administration & dosage; D014808:Vitamin D Deficiency / Q000150:complications* / Q000188:drug therapy
chemical_list: D014807:Vitamin D
keywords: Bone mineral density; Cardiovascular disease; Kidney transplantation; Malignancies; New-onset diabetes after transplantation; Vitamin D