title: Low vitamin D exposure is associated with higher risk of infection in renal transplant recipients.
abstract: Vitamin D is a steroid hormone with multiple vital roles within the immune system. Various studies evaluated the influence of vitamin D on infections postrenal transplantation and found contrasting results. This study aimed to assess the relationship between vitamin D status and the incidence of infection in renal transplant recipients.
  
  
  
  This is a retrospective cohort study of adult renal transplant recipients at the University of Pittsburgh Medical Center between 2005 and 2012. Patients were grouped as vitamin D sufficient (≥30 ng/mL) or deficient (<30 ng/mL) based on total serum 25-hydroxyvitamin D concentrations. The association between vitamin D levels collected at any point post-transplantation and incidence of infection within ±90 days of the vitamin D levels were assessed using logistic and Poisson's regression models.
  
  
  
  Vitamin D sufficiency at any point post-transplantation was significantly associated with a 66% lower odds (OR: 0.34; 95% CI: 0.22-0.52; P<.001) and 43% lower rate of infections (incident rate ratio (IRR): 0.57; 95% CI: 0.46-0.71; P<.001) within ±90 days of the vitamin D level. Baseline vitamin D level was also associated with lower incidence and risk for infections within the first year post-transplantation.
  
  
  
  Adequate levels of vitamin D in kidney transplant recipients are associated with lower infection risk in the first year and at any time post-transplantation.
authors.affiliation: Department of Pharmaceutical Sciences, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Hari V
authors.identifier: 0000-0002-5863-2452
authors.initials: HV
authors.lastname: Kalluri
authors.affiliation: Department of Pharmacy, Saint Barnabas Medical Center, Livingston, NJ, USA.
authors.forename: Lauren M
authors.initials: LM
authors.lastname: Sacha
authors.affiliation: Department of Pharmacy, Sentara Norfolk General Hospital, Norfolk, VA, USA.
authors.forename: Amanda I
authors.initials: AI
authors.lastname: Ingemi
authors.affiliation: Department of Pharmacy and Therapeutics, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Shullo
authors.affiliation: Department of Pharmacy and Therapeutics, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Heather J
authors.initials: HJ
authors.lastname: Johnson
authors.affiliation: Department of Surgery, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.|Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Puneet
authors.initials: P
authors.lastname: Sood
authors.affiliation: Department of Surgery, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.|Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Amit D
authors.initials: AD
authors.lastname: Tevar
authors.affiliation: Department of Surgery, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.|Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Abhinav
authors.initials: A
authors.lastname: Humar
authors.affiliation: Department of Pharmaceutical Sciences, University of Pittsburgh, Pittsburgh, PA, USA.|Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, PA, USA.|Department of Pathology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Raman
authors.initials: R
authors.lastname: Venkataramanan
mesh_terms: D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D015994:Incidence; D007239:Infections / Q000453:epidemiology* / Q000209:etiology; D007676:Kidney Failure, Chronic / Q000601:surgery*; D007677:Kidney Function Tests; D016030:Kidney Transplantation / Q000009:adverse effects*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D066027:Transplant Recipients; D014481:United States / Q000453:epidemiology; D014807:Vitamin D / Q000097:blood*; D014808:Vitamin D Deficiency / Q000097:blood / Q000150:complications*
chemical_list: D014807:Vitamin D
keywords: 25-hydroxyvitamin D; calcidiol; calcitriol; infection risk; renal transplantation; vitamin D