25-Hydroxyvitamin D Deficiency and Opportunistic Viral Infections After Kidney Transplant

摘要

Objectives: Vitamin D may modulate immune function. The purpose of this study was to evaluate the association of 25-hydroxyvitamin D level at kidney transplant with outcomes after transplant, including opportunistic viral infections (cyto-megalovirus infection and BK viremia), acute allograft rejection, and delayed graft function. Materials and Methods: A retrospective review was performed in kidney transplant recipients who had 25-hydroxyvitamin D levels drawn within 30 days before or after of transplant from January 2004 to May 2009 at Henry Ford Hospital and who were followed for 1 year after transplant. Results: There were 89 patients included in the study (mean age, 51 ± 14 y; male, 66%; African American, 49%; living-donor transplant, 26%). There was a significantly lower frequency of opportunistic viral infections in the vitamin D sufficient group (3 patients, 12%) than vitamin D insufficient group (24 patients, 38%; P ≤ .01). Multivariate analysis showed that male sex and vitamin D insufficiency were independently associated with increased incidence of opportunistic viral infection. Conclusions: In kidney transplant recipients, male sex and vitamin D insufficiency are inde-pendently associated with increased incidence of opportunistic viral infection. The risk of developing opportunistic viral infections after kidney transplant may be modified by ensuring adequate 25-hydroxy-vitamin D levels before transplant.