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Vitamin D deficiency in a renal transplant population: safe repletion with moderate doses of calcidiol.

Abstract：

BACKGROUND:Deficits of vitamin D are a common finding in the general population, especially among patients with chronic kidney disease. However, there are not much data about its prevalence after renal transplantation. Our aim was to analyze the calcidiol status among a cohort of kidney transplant recipients, in a region of Spain with a high number of annual sunshine hours, as well as the effects of supplementation with oral calcidiol. PATIENTS AND METHODS:We included 110 kidney transplant recipients in a retrospective observational study. Measurements of 25-hydroxyvitamin D (25OHD), calcium, phosphate, intact parathyroid hormone (iPTH), serum creatinine and albumin, 24-hour microalbuminuria, and proteinuria were performed at the same time. Patients were classified based on their serum 25OHD levels: normal (>30 ng/mL); insufficiency (16-30 ng/mL); and deficiency (<16 ng/mL). In a second analysis, we included 63 patients with 25OHD<30 ng/mL with adjusted calcium levels below 10.2 mg/dL for treatment with oral calcidiol to approach target levels of 30 to 40 ng/mL. Mineral metabolism parameters were monitored at baseline as well as 6 and 12 months after beginning treatment. RESULTS:Insufficient or deficient 25OHD levels were present in 106/110 patients (96.3%); they were normal in just four patients (3.6%). Patients with calcidiol deficiency were older. We observed no differences in sex, posttransplant follow up, serum calcium, phosphate, iPTH, glomerular filtration rate, or 24- hour albuminuria or proteinuria. The 63 patients treated with oral calcidiol received a mean dose of 8044±4087 IU/wk at baseline. The 61.3% of them with deficient 25OHD levels at baseline decreased to 2.1% at 6 months and 7.5% at 12 months after treatment. No significant changes in calcium, phosphate or iPTH were observed during the treatment. CONCLUSIONS:Deficits of 25 OHD was frequent after renal transplantation but improved safely with moderate doses of oral calcidiol without negative secondary effects.

journal_name

Transplant Proc

journal_title

Transplantation proceedings

authors

Kanter Berga J,Crespo Albiach J,Beltran Catalan S,Gavela Martinez E,Sancho Calabuig A,Avila Bernabeu A,Pallardo Mateu LM

doi

10.1016/j.transproceed.2010.08.015

subject

Has Abstract

pub_date

2010-10-01 00:00:00

pages

2917-20

issue

eissn

0041-1345

issn

1873-2623

pii

S0041-1345(10)01215-7

journal_volume

pub_type

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Vitamin D deficiency in a renal transplant population: safe repletion with moderate doses of calcidiol.