Kalluri Hari V, Sacha Lauren M, Ingemi Amanda I, Shullo Michael A, Johnson Heather J, Sood Puneet, Tevar Amit D, Humar Abhinav, Venkataramanan Raman
Department of Pharmaceutical Sciences, University of Pittsburgh, Pittsburgh, PA, USA.
Department of Pharmacy, Saint Barnabas Medical Center, Livingston, NJ, USA.
Clin Transplant. 2017 May;31(5). doi: 10.1111/ctr.12955. Epub 2017 Apr 4.
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.
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.
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.
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.
维生素D是一种类固醇激素,在免疫系统中发挥多种重要作用。多项研究评估了维生素D对肾移植后感染的影响,但结果相互矛盾。本研究旨在评估肾移植受者维生素D状态与感染发生率之间的关系。
这是一项对2005年至2012年匹兹堡大学医学中心成年肾移植受者的回顾性队列研究。根据血清总25-羟维生素D浓度,将患者分为维生素D充足(≥30 ng/mL)或缺乏(<30 ng/mL)两组。使用逻辑回归和泊松回归模型评估移植后任何时间点采集的维生素D水平与维生素D水平±90天内感染发生率之间的关联。
移植后任何时间点的维生素D充足与维生素D水平±90天内感染几率显著降低66%(OR:0.34;95%CI:0.22-0.52;P<0.001)以及感染率降低43%(发病率比(IRR):0.57;95%CI:0.46-0.71;P<0.001)相关。基线维生素D水平也与移植后第一年感染的较低发生率和风险相关。
肾移植受者充足的维生素D水平与第一年及移植后任何时间的较低感染风险相关。