Abstract
Introduction: Vitamin D deficiency can impact post-transplant outcomes due to its effect on graft
function and rejection. The effect of pre- and post-transplant serum vitamin D levels was evaluated
on graft function.
Objectives: This study aims to determine the incidence of vitamin D deficiency and its effect on
post kidney transplant allograft function in a North Indian cohort.
Patients and Methods: We evaluated 57 patients on dialysis, going for transplantation. Estimated
glomerular filtration rate (eGFR) was measured using modification of diet in renal disease (MDRD)
formula at 2 weeks and 3, 6, 12 months interval after kidney transplantation.
Results: Pre- and post-transplant (3 months) vitamin D levels were evaluated for vitamin D
deficiency and graft function. Before transplant vitamin D levels were 25.77 ± 13.68 ng/mL, 40.4%
of these recipients had vitamin D deficiency (levels <20 ng/mL). After transplant, vitamin D levels
at 3 months were 22.08 ± 11.15 ng/mL and 54.4% of recipients had vitamin D deficiency. No patient
was on vitamin D supplementation after transplantation. At 3 months post-transplant, recipients
with vitamin D levels <20 ng/mL, had significantly lower eGFR and higher serum creatinine value
as compared to the group with vitamin D levels >20ng/mL. Recipients were divided into 3 groups
based on pre- and post-transplant vitamin D levels (<20, 20-30 and >30ng/mL). Pre-transplant
vitamin D levels correlated with graft function at 14 days. On multiple regression analysis, 3-month
post-transplant vitamin D levels correlated with 12 months eGFR. There was increased incidence
of acute rejection episodes in vitamin D deficiency group.
Conclusion: There is a high incidence of vitamin D deficiency and insufficiency in kidney
transplant recipients. Low levels of post-transplant vitamin D levels at 3 months were associated
with inferior allograft function (eGFR) at 1 year.