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Abstract: FR-PO1161

Vitamin D Status in a Cohort of Renal Transplanted Patients: Factors Related and Impact on Rejection Occurrence and Long-Term Graft Outcome

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Regalia, Anna, Fondazione IRCCS Ca Granda- Ospedale Maggiore Policlinico Milano, Milano, Milano, Italy
  • Alfieri, Carlo M., Fondazione IRCCS Ca Granda- Ospedale Maggiore Policlinico Milano, Milano, Italy
  • Ruzhytska, Oksana, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
  • Gandolfo, Maria Teresa, Fondazione IRCCS Ca Granda- Ospedale Maggiore Policlinico Milano, Milano, Milano, Italy
  • Cresseri, Donata Carmela, Fondazione IRCCS Ca Granda- Ospedale Maggiore Policlinico Milano, Milano, Milano, Italy
  • Campise, Mariarosaria, Fondazione IRCCS Ca Granda- Ospedale Maggiore Policlinico Milano, Milano, Milano, Italy
  • Messa, Piergiorgio, Fondazione IRCCS Ca Granda- Ospedale Maggiore Policlinico Milano, Milano, Italy
Background

Immunomodulatory properties in renal transplant (RTx) have been hypothesized for vitamin D (VD). We evaluated retrospectively, in a cohort of renal transplanted patients (RTxp): a) VD status at 1 (T1) and 12 (T12) months after RTx; b) the factors related to VD status; c) the impact of VD status on rejection rate and long term graft outcome.

Methods

The study includes 438 (M=265;age 49[40-50]years), out of 670 patients (pts) transplanted between April 2004 and November 2017, where VD status parameters were available both at T1 and T12. Included and not included pts did not differ in general features. VD status, based on 25OH-VD levels, was categorized as: insufficient (iVD) or sufficient (sVD), if 25OH-VD was < or ≥30 ng/mL, respectively. Patients were followed-up for 65[33-97] months and evaluated for rejection rate, diagnosed on renal biopsy (RBx) performed for clinical indication, and for achieving combined major adverse clinical events (MACE: death or graft failure, considered as either return to dialysis or eGFR halving).

Results

A) 25OH-VD levels increased from 14[8-18] ng/mL at T1 to 17[10-23] ng/mL at T12 (p<0.0001), with iVD being present in 425 (97%) pts at T1 and in 380 (87%) pts at T12. VD status normalized spontaneously or after VD supplementation in 19 and 35 pts, respectively; 9 sVD pts at T1 were iVD at T12.
b) 25OH-VD levels were negatively related with PTH both at T1 and T12, while they were positively related with Ca levels at T12.
c) Rejection (REJ+) was diagnosed in 38 (36%) out of the 105 RTxp submitted to RBx. No difference was found in 25OH-VD levels between REJ+ and REJ- pts, both at T1 and T12. MACE occurred in 66 (15%) pts (MACE+). 25OH-VD levels at T12 were significantly lower in MACE+ pts and were the only variable significantly associated with MACE+ at multivariate analysis (OR=0.96, p= 0.01).

Conclusion

With the limitations of the retrospective design and the relatively low number of pts, we found that: a) iVD was highly prevalent in RTx patients both at T1 and T12; b) VD levels were inversely related with PTH levels; c) no association was found between VD status and REJ occurrence, while 25OH-VD levels at T12 were inversely and independently related to MACE+.