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25(OH)D-but not 1,25(OH)2D-is an independent risk factor predicting graft loss in stable kidney transplant recipients

BackgroundVitamin D deficiency (VDD) or vitamin D insufficiency is common in kidney transplant recipients (KTRs). The impact of VDD on clinical outcomes in KTRs remain poorly defined and the most suitable marker for assessing vitamin D nutritional status in KTRs is unknown so far.MethodsWe conducted...

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Main Authors: Zeng, Shufei (Author) , Yang, Yide (Author) , Li, Shuping (Author) , Hocher, Carl-Friedrich (Author) , Chu, Chang (Author) , Wang, Ziqiang (Author) , Zheng, Zhihua (Author) , Krämer, Bernhard (Author) , Hocher, Berthold (Author)
Format: Article (Journal)
Language:English
Published: 20 April 2023
In: Frontiers in medicine
Year: 2023, Volume: 10, Pages: 1-10
ISSN:2296-858X
DOI:10.3389/fmed.2023.1141646
Online Access:Resolving-System, kostenfrei, Volltext: https://doi.org/10.3389/fmed.2023.1141646
Verlag, kostenfrei, Volltext: https://www.frontiersin.org/articles/10.3389/fmed.2023.1141646
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Author Notes:Shufei Zeng, Yide Yang, Shuping Li, Carl-Friedrich Hocher, Chang Chu, Ziqiang Wang, Zhihua Zheng, Bernhard K. Krämer and Berthold Hocher
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Summary:BackgroundVitamin D deficiency (VDD) or vitamin D insufficiency is common in kidney transplant recipients (KTRs). The impact of VDD on clinical outcomes in KTRs remain poorly defined and the most suitable marker for assessing vitamin D nutritional status in KTRs is unknown so far.MethodsWe conducted a prospective study including 600 stable KTRs (367 men, 233 women) and a meta-analysis to pool existing evidence to determine whether 25(OH)D or 1,25(OH)2D predicted graft failure and all-cause mortality in stable KTRs.ResultsCompared with a higher 25(OH)D concentration, a low concentration of 25(OH)D was a risk factor for graft failure (HR 0.946, 95% CI 0.912−0.981, p = 0.003), whereas 1,25 (OH)2D was not associated with the study end-point graft loss (HR 0.993, 95% CI 0.977−1.009, p = 0.402). No association was found between either 25(OH)D or 1,25 (OH)2D and all-cause mortality. We furthermore conducted a meta-analysis including 8 studies regarding the association between 25(OH)D or 1,25(OH)2D and graft failure or mortality, including our study. The meta-analysis results were consistent with our study in finding that lower 25(OH)D levels were significantly associated with the risk of graft failure (OR = 1.04, 95% CI: 1.01−1.07), but not associated with mortality (OR = 1.00, 95% CI: 0.98−1.03). Lower 1,25(OH)2D levels were not associated with the risk of graft failure (OR = 1.01, 95% CI: 0.99−1.02) and mortality (OR = 1.01, 95% CI: 0.99−1.02).ConclusionBaseline 25(OH)D concentrations but not 1,25(OH)2D concentrations were independently and inversely associated with graft loss in adult KTRs.
Item Description:Gesehen am 10.07.2023
Physical Description:Online Resource
ISSN:2296-858X
DOI:10.3389/fmed.2023.1141646

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