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25-Hydroxyvitamin D Insufficiency Is Associated with Higher Risk of BK Virus Re-Activation After Kidney Transplantation.

N. Elfadawy,1 S. Flechner,2 E. Poggio,2 B. Stephany,2 R. Fatica,2 J. Schold,2 S. Mossad.2

1Internal Medicine, Case Western Reserve University, Cleveland, OH
2Cleveland Clinic, Cleveland, OH.

Meeting: 2016 American Transplant Congress

Abstract number: 433

Keywords: Kidney transplantation, Polyma virus

Session Information

Date: Tuesday, June 14, 2016

Session Name: Concurrent Session: Kidney: Polyomavirus

Session Time: 2:30pm-4:00pm

 Presentation Time: 2:30pm-2:42pm

Location: Room 210

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BACKGROUND: The past decade has seen increased interest in vitamin D, as new data suggest that it plays a role in the immune system. The purpose of this study was to investigate the effect of 25-hydroxyvitD level (25[OH]D) after kidney transplant on the risk of BK virus reactivation. METHODS: We identified 498 kidney allograft recipients (2007-11) who had serum levels of (25[OH]D), and PTH measured within the first year of transplantation. We evaluated the relationship between the average circulating levels of 25(OH)D and PTH and BK virus reactivation in blood. RESULTS: Vitamin D insufficiency – defined as average circulating levels of 25[OH]D <30 ng/mL-using The Endocrine Society Clinical Practice 2011 Guideline- was observed in 377 (75%) of 498 kidney graft recipients after kidney transplant. The VitD insufficient and sufficient groups were comparable in terms of gender, age, BMI, race, and immunosuppression regimen. Vitamin D insuffiency was more frequent in recipients of cadaveric allografts (P=0.009, Fisher exact test). By multivariable Cox regression analysis, vitamin D insuffiency was an independent risk factor for BKV reactivation after kidney transplantation (hazard ratio=2.4, 95% CI 1.3-4.7, P=0.002). Moreover, vitD insuffiency was associated with significantly earlier onset of BKV reactivation (8.8 vs15.6 months resp, P 0.01). Receiver operating characteristic analysis using logistic regression showed that 25[OH]D < 24ng/mL was predictive of BKV reactivation(OR:82.9, 95% CI: 17.22–744.6, P < 0.001, AUC 0.7). Vitamin D insufficiency was not associated with higher risk of CMV reactivation (16.7 vs 19% resp, p 0.5). The positive BKV group had significantly higher PTH compared to the negative group (196.7 vs 148.5 resp, P 0.01). No significant associations of 25[OH]D with clinical outcomes were observed in time-dependent or fixed-covariate Cox models. CONCLUSIONS: Vitamin D insufficiency is an independent risk factor for BKV reactivation after kidney transplantation. prospective clinical trials are warranted.

CITATION INFORMATION: Elfadawy N, Flechner S, Poggio E, Stephany B, Fatica R, Schold J, Mossad S. 25-Hydroxyvitamin D Insufficiency Is Associated with Higher Risk of BK Virus Re-Activation After Kidney Transplantation. Am J Transplant. 2016;16 (suppl 3).

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To cite this abstract in AMA style:

Elfadawy N, Flechner S, Poggio E, Stephany B, Fatica R, Schold J, Mossad S. 25-Hydroxyvitamin D Insufficiency Is Associated with Higher Risk of BK Virus Re-Activation After Kidney Transplantation. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/25-hydroxyvitamin-d-insufficiency-is-associated-with-higher-risk-of-bk-virus-re-activation-after-kidney-transplantation/. Accessed April 21, 2021.

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