Hari V Kalluri1, Lauren M Sacha2, Amanda I Ingemi3, Michael A Shullo4, Heather J Johnson4, Puneet Sood5,6, Amit D Tevar5,6, Abhinav Humar5,6, Raman Venkataramanan1,6,7. 1. Department of Pharmaceutical Sciences, University of Pittsburgh, Pittsburgh, PA, USA. 2. Department of Pharmacy, Saint Barnabas Medical Center, Livingston, NJ, USA. 3. Department of Pharmacy, Sentara Norfolk General Hospital, Norfolk, VA, USA. 4. Department of Pharmacy and Therapeutics, University of Pittsburgh, Pittsburgh, PA, USA. 5. Department of Surgery, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA. 6. Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, PA, USA. 7. Department of Pathology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Abstract
BACKGROUND: Vitamin D is a steroid hormone with multiple vital roles within the immune system. Various studies evaluated the influence of vitamin D on infections postrenal transplantation and found contrasting results. This study aimed to assess the relationship between vitamin D status and the incidence of infection in renal transplant recipients. METHODS: This is a retrospective cohort study of adult renal transplant recipients at the University of Pittsburgh Medical Center between 2005 and 2012. Patients were grouped as vitamin D sufficient (≥30 ng/mL) or deficient (<30 ng/mL) based on total serum 25-hydroxyvitamin D concentrations. The association between vitamin D levels collected at any point post-transplantation and incidence of infection within ±90 days of the vitamin D levels were assessed using logistic and Poisson's regression models. RESULTS: Vitamin D sufficiency at any point post-transplantation was significantly associated with a 66% lower odds (OR: 0.34; 95% CI: 0.22-0.52; P<.001) and 43% lower rate of infections (incident rate ratio (IRR): 0.57; 95% CI: 0.46-0.71; P<.001) within ±90 days of the vitamin D level. Baseline vitamin D level was also associated with lower incidence and risk for infections within the first year post-transplantation. CONCLUSION: Adequate levels of vitamin D in kidney transplant recipients are associated with lower infection risk in the first year and at any time post-transplantation.
BACKGROUND:Vitamin D is a steroid hormone with multiple vital roles within the immune system. Various studies evaluated the influence of vitamin D on infections postrenal transplantation and found contrasting results. This study aimed to assess the relationship between vitamin D status and the incidence of infection in renal transplant recipients. METHODS: This is a retrospective cohort study of adult renal transplant recipients at the University of Pittsburgh Medical Center between 2005 and 2012. Patients were grouped as vitamin D sufficient (≥30 ng/mL) or deficient (<30 ng/mL) based on total serum 25-hydroxyvitamin D concentrations. The association between vitamin D levels collected at any point post-transplantation and incidence of infection within ±90 days of the vitamin D levels were assessed using logistic and Poisson's regression models. RESULTS:Vitamin D sufficiency at any point post-transplantation was significantly associated with a 66% lower odds (OR: 0.34; 95% CI: 0.22-0.52; P<.001) and 43% lower rate of infections (incident rate ratio (IRR): 0.57; 95% CI: 0.46-0.71; P<.001) within ±90 days of the vitamin D level. Baseline vitamin D level was also associated with lower incidence and risk for infections within the first year post-transplantation. CONCLUSION: Adequate levels of vitamin D in kidney transplant recipients are associated with lower infection risk in the first year and at any time post-transplantation.