The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
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Vitamin D deficiency is associated with increased risk of bacterial infections after kidney transplantation

  • Park, Young-Jae (Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Kim, Sang-Un (Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Lee, Kyung-Hee (Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Lee, Jong-Hak (Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Kwon, Eugene (Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Jung, Hee-Yeon (Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Choi, Ji-Young (Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Cho, Jang-Hee (Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Park, Sun-Hee (Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Kim, Yong-Lim (Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Kim, Hyung-Kee (Department of Surgery, Kyungpook National University School of Medicine) ;
  • Huh, Seung (Department of Surgery, Kyungpook National University School of Medicine) ;
  • Kim, Chan-Duck (Department of Internal Medicine, Kyungpook National University School of Medicine)
  • Received : 2015.07.11
  • Accepted : 2016.09.09
  • Published : 2017.05.01
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Abstract

Background/Aims: There may be an association between vitamin D levels and allograft outcomes in kidney transplant recipients (KTRs). However, few studies have been conducted to determine the association between vitamin D levels and post-transplant infections. This study investigated the impact of vitamin D deficiency on the risk of infection after kidney transplantation. Methods: We measured 25-hydroxyvitamin D (25(OH)D) levels prior to kidney transplantation. Vitamin D deficiency was defined as a serum 25(OH)D level < 20 ng/mL. We examined the incidence of various post-transplant infections during follow-up period. We used Cox proportional hazards regression analysis to determine factors associated with increased risk of post-transplant infections during the follow-up period. Results: A total of 164 KTRs were followed up for a mean of $24.8{\pm}10.7$ months. Among them, 135 patients (82.3%) had vitamin D deficiency. Patients with vitamin D deficiency had a significantly higher incidence of urinary tract infection (p = 0.027) and any bacterial infection (p = 0.010) compared to those without vitamin D deficiency. Vitamin D deficiency was not significantly associated with incidence of viral or fungal infections. Cox proportional hazards regression analysis revealed that vitamin D deficiency (hazard ratio, 11.07; 95% confidence interval, 1.46 to 84.03; p = 0.020) was independent risk factor for post-transplant bacterial infections. Conclusions: Pre-transplant vitamin D deficiency was a significant risk factor for bacterial infections after kidney transplantation. Further studies are needed on possible benefits of vitamin D supplementation for preventing post-transplant bacterial infection.

Keywords

Acknowledgement

Supported by : Ministry of Health and Welfare

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