Vitamin D as a risk factor for patient survival after kidney transplantation: A prospective observational cohort study

Abstract

Background: Short-term survival after kidney transplantation is excellent, but longterm survival remains low and is equivalent to non-end-stage renal disease patients with many invasive malignancies. The aim of the study was to explore vitamin D status in the early phase after transplantation as a prognostic marker for long-term graft and patient survival. Methods: All first-time kidney transplant recipients between October 2007 and October 2012 in Norway were included. Vitamin D was measured 10 weeks posttransplant. Information on graft failure and death was obtained from the Norwegian Renal Registry. Results: Seven hundred and sixty-two first-time kidney transplant recipients were included, with a median age of 57 years and a median follow-up of 82 months. In the follow-up period, there were 172 graft failures (23%) and 118 deaths (15%). Eightysix percent of the transplant recipients with sufficient vitamin D levels were alive with a well-functioning graft after 5 years using Kaplan-Meier survival estimates, compared with 79% and 76% of the patients with vitamin D deficiency and insufficiency, respectively (P = 0.006). Conclusion: In a nation-wide cohort of 762 first-time kidney transplant recipients, long-term graft and patient survival were better in recipients with vitamin D sufficiency 10 weeks post-transplant compared with those with vitamin D deficiency and insufficiency. K E Y W O R D S kidney transplantation, mortality, survival analysis, vitamin D

Vitamin D status in an Australian patient population: a large retrospective case series focusing on factors associated with variations in serum 25(OH)D

“…The majority of patients from nephrology at RMH were treated for chronic kidney disease (CKD). Vitamin D levels are generally low in these patients, as CKD is associated with low levels of vitamin D, especially in patients with end-stage renal disease and kidney transplant recipient 55–59. Our findings are consistent with results from previous studies that demonstrated the association between low vitamin D levels and CKD.…”

Elevated Terminal C5b-9 Complement Complex 10 Weeks Post Kidney Transplantation Was Associated With Reduced Long-Term Patient and Kidney Graft Survival

“…Written informed consent was obtained from all patients before any data and biological material were included in the Norwegian Renal Registry and the biobank. Other analyses from the study have been presented previously (25)(26)(27). Included in this analysis were 900 consecutively transplanted adult kidney recipients in the period October 15, 2007, to October 18, 2012, from each of whom a 10-week blood sample was biobanked.…”

The Role of Vitamin D in Kidney Transplantation Outcomes: A Systematic Review

“…Out of these 196 articles 40 were eligible for full-text analysis. Ultimately, sixteen articles were included in this review [ 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 ] ( Figure 1 ). The rest of the articles were excluded as the design, protocol and/or methodology used investigated a different PICO question to those of our study.…”