Korean J Intern Med.  2017 May;32(3):505-513. 10.3904/kjim.2015.214.

Vitamin D deficiency is associated with increased risk of bacterial infections after kidney transplantation

• Park YJ
• Kim SU
• Lee KH
• Lee JH
• Kwon E
• Jung HY
• Choi JY
• Cho JH
• Park SH
• Kim YL
• Kim HK
• Huh S
• Kim CD

• KMID: 2379481
• DOI: http://doi.org/10.3904/kjim.2015.214

Abstract

BACKGROUND/AIMS
There may be an association between vitamin D levels and allograft outcomes in kidney transplant recipients (KTRs). However, few studies have been conducted to determine the association between vitamin D levels and post-transplant infections. This study investigated the impact of vitamin D deficiency on the risk of infection after kidney transplantation.
METHODS
We measured 25-hydroxyvitamin D (25(OH)D) levels prior to kidney transplantation. Vitamin D deficiency was defined as a serum 25(OH)D level < 20 ng/mL. We examined the incidence of various post-transplant infections during follow-up period. We used Cox proportional hazards regression analysis to determine factors associated with increased risk of post-transplant infections during the follow-up period.
RESULTS
A total of 164 KTRs were followed up for a mean of 24.8 ± 10.7 months. Among them, 135 patients (82.3%) had vitamin D deficiency. Patients with vitamin D deficiency had a significantly higher incidence of urinary tract infection (p = 0.027) and any bacterial infection (p = 0.010) compared to those without vitamin D deficiency. Vitamin D deficiency was not significantly associated with incidence of viral or fungal infections. Cox proportional hazards regression analysis revealed that vitamin D deficiency (hazard ratio, 11.07; 95% confidence interval, 1.46 to 84.03; p = 0.020) was independent risk factor for post-transplant bacterial infections.
CONCLUSIONS
Pre-transplant vitamin D deficiency was a significant risk factor for bacterial infections after kidney transplantation. Further studies are needed on possible benefits of vitamin D supplementation for preventing post-transplant bacterial infection.

Keyword

Vitamin D deficiency; Kidney transplantation; Bacterial infections

MeSH Terms

Allografts
Bacterial Infections*
Follow-Up Studies
Humans
Incidence
Kidney Transplantation*
Kidney*
Risk Factors
Transplant Recipients
Urinary Tract Infections
Vitamin D Deficiency*
Vitamin D*
Vitamins*
Vitamin D
Vitamins