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肾移植受者的血清维生素D水平:免疫抑制方案和阳光照射的重要性。

Serum vitamin D levels in kidney transplant recipients: the importance of an immunosuppression regimen and sun exposure.

作者信息

Eyal Ophir, Aharon Michal, Safadi Rifaat, Elhalel Michal Dranitzki

机构信息

Nephrology Service, Gastroenterology Institute, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.

出版信息

Isr Med Assoc J. 2013 Oct;15(10):628-33.

Abstract

BACKGROUND

Vitamin D deficiency was shown to be prevalent among renal transplant recipients in northern countries, but little is known regarding risk factors.

OBJECTIVES

To test vitamin D levels in kidney transplant recipients residing closer to the equator, compare them to levels in liver transplant recipients and hemodialysis patients, and identify possible risk factors.

METHODS

In a cross-sectional study 103 kidney transplant recipients, 27 liver transplant recipients and 50 hemodialysis patients followed at our institute were tested for vitamin D levels. Demographic data, medical history and current treatment were recorded from the medical files.

RESULTS

Inadequate vitamin D levels (< 30 ng/ml) were found in 75% of all patients and 75% of all kidney transplant recipients. Vitamin D levels were higher among dialysis patients than transplant recipients, though deficiency rates were similar. No association was found between kidney function and vitamin deficiency. Deficiency was associated with higher prednisone doses, use of mycophenolate sodium, tacrolimus, and iron supplements, or lower doses of vitamin D supplementation.

CONCLUSIONS

Despite potential higher ultraviolet B exposure, inadequate vitamin D levels were prevalent in our study group. Importantly, some immunosuppressive medications were associated with vitamin D deficiency and high doses of vitamin D were associated with less deficiency.

摘要

背景

在北方国家,肾移植受者中维生素D缺乏症较为普遍,但对其危险因素知之甚少。

目的

检测居住在赤道附近的肾移植受者的维生素D水平,将其与肝移植受者和血液透析患者的水平进行比较,并确定可能的危险因素。

方法

在一项横断面研究中,对我院随访的103例肾移植受者、27例肝移植受者和50例血液透析患者进行了维生素D水平检测。从病历中记录人口统计学数据、病史和当前治疗情况。

结果

所有患者中有75%以及所有肾移植受者中有75%的维生素D水平不足(<30 ng/ml)。透析患者的维生素D水平高于移植受者,尽管缺乏率相似。未发现肾功能与维生素缺乏之间存在关联。维生素缺乏与泼尼松剂量较高、使用麦考酚钠、他克莫司和铁补充剂或维生素D补充剂剂量较低有关。

结论

尽管可能有更高的紫外线B暴露,但在我们的研究组中维生素D水平不足的情况很普遍。重要的是,一些免疫抑制药物与维生素D缺乏有关,而高剂量的维生素D与较少的缺乏有关。

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