Vitamin D has immunomodulatory and antiinflammatory activity in healty population and in various disease states. There is’nt any data on the quantification of vitamin D status and inflammation and changes in bone mineral density in renal transplantion patients. The influence of vitamin D levels on allograft function and inflammatory status at the time of enrollment and one year follow-up were analyzed.
Sixty four renal transplant patients [38 male age: 38.61 ± 1.05 y, a median graft age of 6,15 ± 3,17 years] were included. Patients who had diabetes mellitus, known to have any chronic inflammatory disease and those with chronic allograft nephropathy were excluded. We obtained pre and post transplantation serum samples and ürinary spot protein in each patient. Measurements of bone mineral density were performed by dual-energy X-ray absortiometry.
After enrollment we followed the patients for one year. At the end of the year we assessed serum creatinine, CRP, albumin and spot urinary protein levels. The patients are divided into two groups by vitamin D levels (Group I: <20 μg/L, Group II: >=20 μg/L). There were no significant difference in iPTH levels of two groups. Vitamin D level was positively correlated with serum creatinine and (r=0.32, p=0.01), serum albumin levels (r=0.28, p=0.023) at the time of enrollment. In the first year follow-up the patients in Group I had significantly higher creatinine (p<0.001) and proteinuria levels (p<0.05) than those in group II. The major risk factor for ostoporosis was found to be high creatinine levels.
Low vitamin D levels are not incommon in renal transplant recipients. There is a significant association of vitamin D level with renal allograft function and low vitamin D level can be a predictor for worsining of graft function and increasing proteinuria.