Date: Saturday, May 30, 2020
Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
*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 May 7, 2021.
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