COMPLICATIONS - METABOLIC

M. Rech¹, J. Fleming¹, C. Moore¹, A. Patel², M.S. Abouljoud^3
1Pharmacy, Henry Ford Hospital, Detroit/UNITED STATES OF AMERICA, ²Transplant Nephrology, Henry Ford Hospital, Detroit/UNITED STATES OF AMERICA, ³Henry Ford Hospital, Transplant Institute, Detroit/UNITED STATES OF AMERICA

Body: Introduction: Vitamin D has been show to play an important role as an immune modulator in addition to it's effect on cell cycle proliferation and metabolic functions. The purpose of this analysis was to evaluate the vitamin D status of kidney transplant recipients at the time of transplant and for up to a year of follow-up. Methods: We performed a retrospective chart review of 66 kidney transplant recipients from 1/2004 - 10/2008 to assess 25-OH vitamin D status at the time of transplant and through one year of follow-up. Results: Five patients (7.6%) were 25-OH vitamin D sufficient (≥30ng/mL) at the time of transplantation, 20 patients (30.6%) were vitamin D insufficient (15-29ng/mL), and 41 patients (62.3%) were vitamin D deficient (<15ng/mL). Thirty-nine (59%) of the 66 patients had follow-up 25-hydroxyvitamin D levels monitored within one year after transplantation. As seen in the table, vitamin D status improved throughout follow-up. Only 15% of patients had lower vitamin D levels at follow-up compared to baseline. Of the 66 patients, 43 (65%) received ergocalciferol within the first 3 months after transplant. Twenty-six of the 43 patients (60%) had levels followed throughout the first year. At last follow-up, 8 (31%) had vitamin D sufficiency, 17 (65%) were vitamin D insufficient, and only 1 patient (4%) remained deficient. On average, 25-OH vitamin D was increased by 10 +/- 10ng/mL. Six patients that did not receive ergocalciferol post-transplant had follow-up vitamin D levels. On average, they had no change in 25-OH vitamin D levels (0 +/- 10). Two of the patients had positive increases in vitamin D levels, but the remaining four all had negative changes to their vitamin D. At the end of follow-up, 1 patient had vitamin D sufficiency, 3 had vitamin D insufficiency, and 2 had deficiency. No significant differences in rejection or infection at one year could be seen in regards to baseline vitamin D status in this small analysis. Conclusion: Vitamin D status is poor at the time of transplantation, but with treatment and monitoring, 25-OH vitamin D levels improve. However, most patients are either not managed or are still suboptimal. More complete monitoring and management is needed in this population. Prospective studies are needed to clarify the effects of vitamin D on graft function.

Disclosure: All authors have declared no conflicts of interest.