Improved Serum Vitamin D Level and Better Cardiovascular Disease Outcomes after Kidney Transplantation
1Department of Internal Medicine, Ewha Womans University Seoul Hospital, Seoul, Korea, Republic of, 2Transplantation Center, Seoul National University Hospital, Seoul, Korea, Republic of, 3Department of Internal Medicine, Hallym University College of Medicine, Seoul, Korea, Republic of, 4Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea, Republic of, 5Department of Surgery, Seoul National University Hospital, Seoul, Korea, Republic of
Meeting: 2020 American Transplant Congress
Abstract number: A-060
Keywords: Kidney transplantation, Morbidity, Outcome
Session Information
Session Name: Poster Session A: Kidney: Cardiovascular and Metabolic Complications
Session Type: Poster Session
Date: Saturday, May 30, 2020
Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
Location: Virtual
*Purpose: Vitamin D deficiency increases cardiovascular disease (CVD) risk through both immunologic and non-immunologic mechanisms. Although vitamin D deficiency is common in end stage renal disease patients, causative evidences of vitamin D in suppressing CVD progression are lacking in kidney transplant (KT) patients. This study aimed to investigate an association between vitamin D status and CVD outcomes in KT patients.
*Methods: The KoreaN cohort study for Outcome in patients With Kidney Transplantation (KNOW-KT) is a multicenter, observational cohort study. The subjects that had been followed for at least 3 years after KT were included in this analysis. CVD outcomes were defined as coronary heart disease events diagnosed by coronary intervention. A total of 420 patients were analyzed.
*Results: Serum 25-OH-vitamin D3 levels were increased after KT (before KT, 12.6±7.4; 1 year after KT, 20.7±9.4; 3 years after KT, 24.7±11.1 ng/mL). Vitamin D deficiency was present in 79.1% just before KT, whereas it was decreased to 57.1%, 30.8% and 34.7% at 1, 3, and 5 years after KT, respectively. When we categorized subjects to vitamin D improvement group and non-improvement group according to change of vitamin D levels after KT, aortic calcification score (Kauppila score) was significantly reduced in vitamin D improved group. The vitamin D improvement group showed a better 5-year patient survival (RR= 0.391, 95%CI: 0.173-0.887) and CV outcomes (RR=0.158, 95%CI: 0.036-0.730). Vascular calcification-related factors such as sclerostin, osteoprotegerin, fetuin-A, and FGF23 were decreased after KT and showed negative correlation with serum vitamin D levels. Higher baseline FGF23 level was negatively correlated with 25-OH-vitamin D3 level until 5 years after transplantation.
*Conclusions: In conclusion, improvement in vitamin D status has a beneficial role in reducing vascular calcification in KT patients and pre-transplant FGF23 monitoring is beneficial to predict improvement in vitamin D level.
To cite this abstract in AMA style:
Ryu J, Koo T, Jeon H, Ahn C, Yang J. Improved Serum Vitamin D Level and Better Cardiovascular Disease Outcomes after Kidney Transplantation [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/improved-serum-vitamin-d-level-and-better-cardiovascular-disease-outcomes-after-kidney-transplantation/. Accessed November 22, 2024.« Back to 2020 American Transplant Congress