25-hydroxyvitamin D deficiency and opportunistic viral infections after kidney transplant

Exp Clin Transplant. 2014 Apr;12(2):95-100.

Abstract

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 (cytomegalovirus 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 independently 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-hydroxyvitamin D levels before transplant.

MeSH terms

  • Adult
  • Aged
  • BK Virus / immunology
  • BK Virus / pathogenicity*
  • Biomarkers / blood
  • Chi-Square Distribution
  • Cytomegalovirus Infections / diagnosis
  • Cytomegalovirus Infections / epidemiology
  • Cytomegalovirus Infections / immunology
  • Cytomegalovirus Infections / virology*
  • Female
  • Humans
  • Immunosuppressive Agents / adverse effects
  • Incidence
  • Kidney Transplantation / adverse effects*
  • Male
  • Michigan / epidemiology
  • Middle Aged
  • Multivariate Analysis
  • Opportunistic Infections / diagnosis
  • Opportunistic Infections / epidemiology
  • Opportunistic Infections / immunology
  • Opportunistic Infections / virology*
  • Polyomavirus Infections / diagnosis
  • Polyomavirus Infections / epidemiology
  • Polyomavirus Infections / immunology
  • Polyomavirus Infections / virology*
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Sex Factors
  • Time Factors
  • Treatment Outcome
  • Tumor Virus Infections / diagnosis
  • Tumor Virus Infections / epidemiology
  • Tumor Virus Infections / immunology
  • Tumor Virus Infections / virology*
  • Vitamin D / analogs & derivatives*
  • Vitamin D / blood
  • Vitamin D Deficiency / blood
  • Vitamin D Deficiency / complications*
  • Vitamin D Deficiency / diagnosis
  • Vitamin D Deficiency / epidemiology
  • Vitamin D Deficiency / immunology

Substances

  • Biomarkers
  • Immunosuppressive Agents
  • Vitamin D
  • 25-hydroxyvitamin D