Mehrotra S, Sharma RK, Mayya M. Vitamin D Receptor Activity, Vitamin D Status, and Development of De-novo Donor-specific Antibody after Renal Transplantation.
Indian J Nephrol 2020;
30:72-76. [PMID:
32269429 PMCID:
PMC7132847 DOI:
10.4103/ijn.ijn_353_18]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 02/02/2019] [Accepted: 02/15/2019] [Indexed: 12/31/2022] Open
Abstract
Introduction:
Vitamin D has immunomodulatory properties and could have a role in allograft outcome.
Methods:
Fifty-two chronic kidney disease patients going for transplantation were studied for vitamin-D receptor (VDR) activity, 25(OH)D, estimated glomerular filtration rate (e-GFR), and de-novo donor-specific antibody (d-DSA).
Results:
Vitamin D deficiency was seen in 25% of recipients before transplant (26.09 ± 12.19 ng/ml), in 48.1% at 6 months posttransplant (23.36 ± 15.11 ng/ml). VDR activity before the transplant was 15.41 ± 31.41 ng/ml, which was similar to control group (13.24 ± 9.78 ng/ml), and after transplantation showed an increase at 3 months to 21.91 ± 38.80 ng/ml and at 6 months to 26.03 ± 53.90 ng/ml. d-DSA developed in 27.3% and 6.7% patients of vitamin D-deficient patients (levels <31 ng/ml) and non-deficient (levels ≥20 ng/ml) patients respectively (P < 0.042). Low VDR activity at 3 months posttransplant was associated with significantly higher d-DSA positivity (33.3%) as compared to the group with normal VDR activity where d-DSA developed only in 5.9% of patients (P < 0.009). Patients with vitamin D levels <20 ng/ml and the group with low VDR activity at 3 months had significantly less e-GFR at 1 year after transplant.
Conclusion:
d-DSA was associated with vitamin D deficiency and low VDR activity with decreased graft GFR at 12 months posttransplant.
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