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Determinants of vitamin D status in long‐term renal transplant patients
Author(s) -
Penny Hugo,
Frame Sharon,
Dickinson Francis,
Garrett Giorgia,
Young Antony R.,
Sarkany Robert,
Chitalia Nihil,
Hampson Geeta,
Goldsmith David
Publication year - 2012
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12039
Subject(s) - medicine , cohort , vitamin d and neurology , secondary hyperparathyroidism , gastroenterology , vitamin , renal transplant , parathyroid hormone , transplantation , calcium
In this study, we explored the determinants of vitamin D status in a large cohort of stable, Long‐term renal transplant (RTx) patients. Serum 25(OH)D concentrations, and bone biochemistry parameters, were retrospectively analyzed from 266 RTx patients (>10 yr post‐engraftment) presenting to clinic over the course of a year. Forty‐five percent of the cohort were vitamin D deficient (<37.5 nM), 38% insufficient (37.5 75–nM), and 17% sufficient (>75 nM). Serum 25(OH)D concentrations were higher in patients presenting in summer (p < 0.001) and in more active patients (p < 0.05). RTx patients with non‐melanoma skin cancer (NMSC) (n = 45) had higher 25(OH)D concentrations than patients without NMSC (n = 221; p < 0.05) despite these patients being older, having worse eGFR, transplanted for longer, and less active physically (p < 0.05). Lower 25(OH)D concentrations were associated with higher PTH concentrations (p < 0.05) which, in the setting of widespread hypovitaminosis, suggests that secondary hyperparathyroidism was common in this cohort. In conclusion, season and activity status are important determinants of vitamin D status. We report, for the first time, that NMSC is associated with higher 25(OH)D, probably through increased UV radiation exposure. Long‐term RTx patients may benefit from oral vitamin D supplementation, but this requires a randomized controlled trial to confirm.