Abstract: TH-PO1013
Vitamin D Deficiency as a Predictor of Graft Loss and Mortality After Kidney Transplantation
Session Information
- Transplantation: Clinical - Outcomes, Malignancy, and Pathology
October 22, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2002 Transplantation: Clinical
Authors
- Molinari, Paolo, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Alfieri, Carlo, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Castellano, Giuseppe, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
Background
Kidney transplantation is the treatment of choice for end-stage renal disease; however, long-term outcomes remain influenced by metabolic and immunological factors. Among these, vitamin D, due to its immunomodulatory effects, may play a prognostic role that has not yet been fully defined.
Methods
A retrospective study was conducted on 1,107 patients who underwent kidney transplantation with a follow-up ≥12 months (median 8.3 years). Levels of 25(OH)D were measured at 1, 6, and 12 months along with anthropometric, clinical and biochemical parameters. During follow-up, graft loss and mortality outcomes were assessed.
Results
In our cohort, we observed a high prevalence of hypovitaminosis D, with median levels progressively increasing during the first year (T1: 14 ng/mL [9.1–20]; T6: 16 [10–24]; T12: 19 [12–27]). Despite an increase related to supplementation, a substantial proportion of patients remained deficient or insufficient.
At 12 months, a relationship emerged between vitamin D status and inflammatory and renal markers: lower vitamin D levels were associated with higher urinary proteinuria (p<0.05, T6) and higher CRP levels (p<0.001, T1).
Most importantly, multivariate analysis showed that vitamin D deficiency in the first year was associated with increased mortality (OR 2.39, 95% CI 1.27–4.50, p=0.007) and graft loss (OR 3.14, 95% CI 1.39–7.11, p=0.006), independently of major known prognostic factors such as proteinuria, kidney function, age and donor type.
Furthermore, the discriminative power of mean annual vitamin D levels was significant for both mortality (AUC 0.636, p<0.0001) and graft loss (AUC 0.620, p=0.001), suggesting a clinically relevant prognostic role.
Conclusion
Vitamin D emerges as a key factor to monitor in the early post-transplant period and may serve as an adjunctive prognostic marker for graft loss and mortality.