25-Hydroxyvitamin D [25(OH)D], but Not 1,25-Dihydroxyvitamin D [1,25(OH)2D], Independently Predicts Kidney Graft Failure: The Wisconsin Allograft Recipient Database (WisARD).

25-Hydroxyvitamin D [25(OH)D], but Not 1,25-Dihydroxyvitamin D [1,25(OH)₂D], Independently Predicts Kidney Graft Failure: The Wisconsin Allograft Recipient Database (WisARD).

B. Astor,¹ M. Melamed,² D. Mandelbrot,¹ A. Djamali.¹

¹University of Wisconsin School of Medicine and Public Health, Madison, WI
²Albert Einstein College of Medicine / Montefiore Medical Center, Bronx, NY

Meeting: 2017 American Transplant Congress

Abstract number: D271

Keywords: Graft failure, Kidney transplantation

Session Information

Session Name: Poster Session D: Long Term Kidney Outcomes

Session Type: Poster Session

Date: Tuesday, May 2, 2017

Session Time: 6:00pm-7:00pm

Presentation Time: 6:00pm-7:00pm

Location: Hall D1

Vitamin D deficiency is common in chronic kidney disease and is associated with cardiovascular events and mortality. Kidney transplant recipients are at elevated risk of vitamin D deficiency, but few studies have assessed its association with graft survival. It remains unclear whether associations with outcomes differ for 25-Hydroxyvitamin D [25(OH)D] compared to its active form, 1,25-Dihydroxyvitamin D [1,25(OH)₂D].

We assessed the relationship of the earliest 25(OH)D measurement, from 3-60 months (mean of 19 months) post-transplant, with graft survival in 1351 kidney transplant recipients from 2000-2014. A total of 268 recipients also had 1,25(OH)₂D measured. Estimated glomerular filtration rate (eGFR) was measured within 30 days of 25(OH)D and those with eGFR <15 mL/min/1.73m² (n=24) were excluded.

25(OH)D and 1,25(OH)₂D were weakly correlated (0.16; p=0.02). eGFR was more strongly correlated with 1,25(OH)₂D (0.35; p<0.001) than 25(OH)D (0.05; p=0.05). A total of 190 graft failures and 267 deaths occurred over a median of 27.8 months of follow-up (55 graft failures and 65 deaths among those with 1,25(OH)₂D measured). Lower 25(OH)D and lower 1,25(OH)₂D were significantly associated with the risk of graft failure in competing risk models. Further adjustment for eGFR strongly attenuated the association of 1,25(OH)₂D with graft failure, while lower 25(OH)D remained associated with risk of graft failure.25(OH)D and 1,25(OH)₂D are only weakly correlated in kidney transplant recipients and 1,25(OH)₂D is more strongly correlated with graft function. Lower 25(OH)D is an independent predictor of graft failure, while the association of 1,25(OH)₂D with graft failure is not independent of graft function. Additional studies including repeated measures of 25(OH)D and 1,25(OH)₂D, specific causes of graft failure, and other outcomes are required to determine whether these relationships may be causal and modifiable.

CITATION INFORMATION: Astor B, Melamed M, Mandelbrot D, Djamali A. 25-Hydroxyvitamin D [25(OH)D], but Not 1,25-Dihydroxyvitamin D [1,25(OH)₂D], Independently Predicts Kidney Graft Failure: The Wisconsin Allograft Recipient Database (WisARD). Am J Transplant. 2017;17 (suppl 3).

To cite this abstract in AMA style:

Astor B, Melamed M, Mandelbrot D, Djamali A. 25-Hydroxyvitamin D [25(OH)D], but Not 1,25-Dihydroxyvitamin D [1,25(OH)₂D], Independently Predicts Kidney Graft Failure: The Wisconsin Allograft Recipient Database (WisARD). [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/25-hydroxyvitamin-d-25ohd-but-not-125-dihydroxyvitamin-d-125oh2d-independently-predicts-kidney-graft-failure-the-wisconsin-allograft-recipient-database-wisard/. Accessed March 26, 2023.

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