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- Title
Vitamin D deficiency and infection risk in kidney transplant recipients: A single‐center cohort study.
- Authors
Morales‐Cartagena, Alejandra; Fernández‐Ruiz, Mario; Corbella, Laura; Ruiz‐Merlo, Tamara; Parra, Patricia; Silva, Jose T.; López‐Medrano, Francisco; San Juan, Rafael; Aguado, José María; González, Esther; Polanco, Natalia; Andrés, Amado; Aramendi, Mercedes
- Abstract
Background: Recent studies have reported an increased susceptibility to infection among vitamin D‐deficient kidney transplant (KT) recipients, although methodological concerns remain. Methods: Serum 25‐hydroxyvitamin D (25(OH)D) levels were measured in 246 KT recipients at post‐transplant months 1, 3, 6 and 12. Vitamin D status was analysed in terms of deficiency (Endocrine Society [<20 ng/mL] and Institute of Medicine [IoM, <12 ng/mL] criteria) and as a continuous variable. Cox models for overall, bacterial and opportunistic infection were adjusted for nutritional status and immunosuppression‐related covariates. Results: Median serum 25(OH)D increased from month 1 (10.5 ng/mL) to month 6 (16.3 ng/mL; P‐value = 0.001). Prevalence of vitamin D deficiency at month 1 ranged from 87.0% to 61.0% (depending on the diagnostic criteria) and significantly decreased over the next months. After adjustment for age and nutritional status, vitamin D deficiency (serum 25(OH)D < 12 ng/mL) at month 1 was an independent risk factor for overall (hazard ratio [HR]: 1.70; 95% confidence interval [CI]: 1.08‐2.69; P‐value = 0.023) and opportunistic infection (HR: 4.05; 95% CI: 1.57‐10.46; P‐value = 0.004), but not for bacterial infection. A protective effect for overall (adjusted HR: 0.76; 95% CI: 0.63‐0.93; P‐value = 0.007) and opportunistic infection (adjusted HR: 0.62; 95% CI: 0.45‐0.86; P‐value = 0.004) was observed when 25(OH)D levels were analyzed per one‐quartile increases. Conclusions: Vitamin D status influences the risk of infection among KT recipients, with the association being particularly evident for opportunistic events and mainly restricted to the early post‐transplant period.
- Publication
Transplant Infectious Disease, 2018, Vol 20, Issue 6, pN.PAG
- ISSN
1398-2273
- Publication type
Article
- DOI
10.1111/tid.12988