The 25-hydroxyvitamin D level in Kidney Transplant Recipients and Its Association With Renal Function and Other Cardio-Metabolic Risk Markers.

BACKGROUND: Vitamin D is the main hormone that plays a critical role in controlling mineral homeostasis. Transplant recipients frequently have altered levels of 25-hydroxyvitamin D (25[OH] D) and 1, 25-hydroxyvitamin (1, 25[OH] D). OBJECTIVES: To explore the status of vitamin D level in renal allograft recipients and its association with renal function and cardio-metabolic risk markers. METHODS: One hundred two adult kidney transplant recipients (KTRs) were included. Clinical history and information about transplantation and immunosuppression were recorded. Blood and urine samples were collected for relevant laboratory tests, including chronic kidney disease (CKD)-mineral and bone disorder markers (Ca, PO4, and 25[OH] D). RESULTS: The mean age was 35 ± 8 years, with a male/female ratio of 89/11%. The transplant duration was 34 ± 26 (4.5-112) months. All donors involved were living-related: fathers comprised 44%, wives 16%, sisters 13%, mothers 11%, and the others 16% (ie, brothers, sons, daughters, uncles, aunts). The immunosuppression regimen included prednisolone and tacrolimus in all, with mycophenolate mofetil in 96%. The estimated glomerular filtration rate showed CKD distribution from stage 1 to 5 in 6%, 29%, 44%, 15%, and 6%, respectively. Vitamin D level was lower in 22% (<20 ng/mL), insufficient (20-30 ng/mL) in 48%, and adequate (>30 ng/mL) in 30%. We compared different clinical and laboratory variables in 3 different vitamin D groups but found no difference in cardio-renal risk factors (P = Not Significant). Similarly, no correlation was seen between vitamin D levels and other clinical and metabolic factors. CONCLUSION: According to conventional cutoffs, the vitamin D (25[OH] D) level is inadequate in 70% of renal allograft recipients. The hormone level has no apparent association with renal function and major cardio-metabolic risk factors.

Quality of Life Is Improved in Renal Transplant Recipients Versus That Shown in Patients With Chronic Kidney Disease With or Without Dialysis.

OBJECTIVES: Health-related quality of life is increasingly used as an important measurement of treatment outcome. Here, quality of life parameters in renal transplant recipients were evaluated and compared with patients with chronic kidney disease on maintenance hemodialysis and with those who were not on dialysis. MATERIALS AND METHODS: This cross-sectional study included patients seen at a number of tertiary renal care hospitals (there were 15 renal transplant recipients, 20 patients on maintenance hemodialysis, and 28 patients with chronic kidney disease not on dialysis). Forty healthy individual were also included as the control group. Different biochemical parameters were analyzed. Quality of life was assessed with the KDQOL-SF-36 (version 1.3) questionnaire. RESULTS: Mean age was 39 ± 11 for transplant patients, 43 ± 11 years for patients on hemodialysis, 49 ± 12 years for patients with chronic kidney disease not on dialysis, and 34 ± 11 years for the healthy control group. Distribution of sex was similar. Transplant recipients had higher quality of life scores, with some scores similar to healthy controls patients, like physical function (P = .85) and social function (P = .25). Scores were 100 ± 12, 69 ± 27, 37 ± 28, and 91 ± 10 (P < .001) for physical function; 94 ± 12, 44 ± 17, 30 ± 14, and 69 ± 29 (P < .001) for pain; 99 ± 11, 61 ± 46, 24 ± 15, and 70 ± 28 (P < .001) for social function; and 91 ± 11, 51 ± 13, 40 ± 7, and 66 ± 11 (P < .001) for energy/fatigue in healthy control, chronic kidney disease patients not on dialysis, hemodialysis patients, and transplant recipients, respectively. CONCLUSIONS: Quality of life is poor in patients with chronic kidney disease. However, renal transplant can improve quality of life. Transplant patients showed many quality of life scores similar to healthy individuals.