title: Current evidence on vitamin D deficiency and kidney transplant: What's new?
abstract: Kidney transplant is the treatment of choice for end-stage chronic kidney disease. Kidneys generate 1,25-dihydroxyvitamin D (calcitriol) from 25-hydroxyvitamin D (calcidiol) for circulation in the blood to regulate calcium levels. Transplant patients with low calcidiol levels have an increased risk of metabolic and endocrine problems, cardiovascular disease, type 2 diabetes mellitus, poor graft survival, bone disorders, cancer, and mortality rate. The recommended calcidiol level after transplant is at least 30 ng/mL (75 nmol/L), which could require 1000-3000 IU/d vitamin D3 to achieve. Vitamin D3 supplementation studies have found improved endothelial function and acute rejection episodes. However, since kidney function may still be impaired, raising calcidiol levels may not lead to normal calcitriol levels. Thus, supplementation with calcitriol or an analog, alfacalcidiol, is often employed. Some beneficial effects found include possible improved bone health and reduced risk of chronic allograft nephropathy and cancer.
authors.affiliation: General Surgery and Transplantation Unit - "San Giovanni di Dio e Ruggi D'Aragona" University Hospital, Scuola Medica Salernitana, 84131, Salerno, Italy. gsarno79@yahoo.it.
authors.forename: Gerardo
authors.initials: G
authors.lastname: Sarno
authors.affiliation: General Surgery and Transplantation Unit - "San Giovanni di Dio e Ruggi D'Aragona" University Hospital, Scuola Medica Salernitana, 84131, Salerno, Italy.|Nephrology and Dialisys Unit - "Santa Maria della Misericordia" Hospital, ASUIUD - Udine, Udine, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Nappi
authors.affiliation: Institute of Medical Pathology, Division of Endocrinology and Metabolic Diseases, Catholic University, Rome, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Altieri
authors.affiliation: Division of Endocrinology, Department of Clinical and Molecular Sciences, Umberto I Hospital, Polytechnic University of Marche, Ancona, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Tirabassi
authors.affiliation: Catholic University, Rome, Italy.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Muscogiuri
authors.affiliation: Division of Endocrinology, Department of Clinical and Molecular Sciences, Umberto I Hospital, Polytechnic University of Marche, Ancona, Italy.
authors.forename: Gianmaria
authors.initials: G
authors.lastname: Salvio
authors.affiliation: Division of Endocrinology and Diabetes, "Aghia Sophia" Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Stavroula A
authors.initials: SA
authors.lastname: Paschou
authors.affiliation: General Surgery and Transplantation Unit - "San Giovanni di Dio e Ruggi D'Aragona" University Hospital, Scuola Medica Salernitana, 84131, Salerno, Italy.
authors.forename: Aristide
authors.initials: A
authors.lastname: Ferrara
authors.affiliation: General Surgery and Transplantation Unit - "San Giovanni di Dio e Ruggi D'Aragona" University Hospital, Scuola Medica Salernitana, 84131, Salerno, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Russo
authors.affiliation: General Surgery and Transplantation Unit - "San Giovanni di Dio e Ruggi D'Aragona" University Hospital, Scuola Medica Salernitana, 84131, Salerno, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Vicedomini
authors.affiliation: General Surgery and Transplantation Unit - "San Giovanni di Dio e Ruggi D'Aragona" University Hospital, Scuola Medica Salernitana, 84131, Salerno, Italy.
authors.forename: Cerbone
authors.initials: C
authors.lastname: Vincenzo
authors.affiliation: Department of Endocrinology and Diabetes, Hellenic Red Cross Hospital, Athens, Greece.
authors.forename: Andromachi
authors.initials: A
authors.lastname: Vryonidou
authors.affiliation: Institute of Medical Pathology, Division of Endocrinology and Metabolic Diseases, Catholic University, Rome, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Della Casa
authors.affiliation: Division of Endocrinology, Department of Clinical and Molecular Sciences, Umberto I Hospital, Polytechnic University of Marche, Ancona, Italy.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Balercia
authors.affiliation: Endocrinology, Department of Sports Science and Wellness, "Parthenope" University Naples, Naples, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Orio
authors.affiliation: General Surgery and Transplantation Unit - "San Giovanni di Dio e Ruggi D'Aragona" University Hospital, Scuola Medica Salernitana, 84131, Salerno, Italy.
authors.forename: Paride
authors.initials: P
authors.lastname: De Rosa
mesh_terms: D002117:Calcitriol / Q000378:metabolism; D019587:Dietary Supplements; D006801:Humans; D007668:Kidney / Q000378:metabolism; D007676:Kidney Failure, Chronic / Q000097:blood / Q000378:metabolism / Q000628:therapy*; D016030:Kidney Transplantation / Q000009:adverse effects*; D014807:Vitamin D / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000378:metabolism; D014808:Vitamin D Deficiency / Q000209:etiology* / Q000378:metabolism / Q000517:prevention & control
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D; D002117:Calcitriol
keywords: Bone mineral density; Cardiovascular disease; Kidney graft survival; Kidney transplantation; Malignancies; Vitamin D