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Current evidence on vitamin D deficiency and kidney transplant: What’s new?

Reviews in Endocrine and Metabolic Disorders volume 18, pages 323–334 (2017)Cite this article

Abstract

Kidney transplant is the treatment of choice for end-stage chronic kidney disease. Kidneys generate 1,25-dihydroxyvitamin D (calcitriol) from 25-hydroxyvitamin D (calcidiol) for circulation in the blood to regulate calcium levels. Transplant patients with low calcidiol levels have an increased risk of metabolic and endocrine problems, cardiovascular disease, type 2 diabetes mellitus, poor graft survival, bone disorders, cancer, and mortality rate. The recommended calcidiol level after transplant is at least 30 ng/mL (75 nmol/L), which could require 1000–3000 IU/d vitamin D3 to achieve. Vitamin D3 supplementation studies have found improved endothelial function and acute rejection episodes. However, since kidney function may still be impaired, raising calcidiol levels may not lead to normal calcitriol levels. Thus, supplementation with calcitriol or an analog, alfacalcidiol, is often employed. Some beneficial effects found include possible improved bone health and reduced risk of chronic allograft nephropathy and cancer.

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Acknowledgements

This manuscript was neither prepared nor funded in any part by a commercial organization. We thank William B. Grant, MD, for his kind assistance.

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Authors and Affiliations

  1. General Surgery and Transplantation Unit - “San Giovanni di Dio e Ruggi D’Aragona” University Hospital, Scuola Medica Salernitana, 84131, Salerno, Italy

    Gerardo Sarno, Riccardo Nappi, Aristide Ferrara, Enrico Russo, Daniela Vicedomini, Cerbone Vincenzo & Paride De Rosa

  2. Nephrology and Dialisys Unit - “Santa Maria della Misericordia” Hospital, ASUIUD – Udine, Udine, Italy

    Riccardo Nappi

  3. Institute of Medical Pathology, Division of Endocrinology and Metabolic Diseases, Catholic University, Rome, Italy

    Barbara Altieri & Silvia Della Casa

  4. Division of Endocrinology, Department of Clinical and Molecular Sciences, Umberto I Hospital, Polytechnic University of Marche, Ancona, Italy

    Giacomo Tirabassi, Gianmaria Salvio & Giancarlo Balercia

  5. Catholic University, Rome, Italy

    Emanuele Muscogiuri

  6. Division of Endocrinology and Diabetes, “Aghia Sophia” Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece

    Stavroula A. Paschou

  7. Department of Endocrinology and Diabetes, Hellenic Red Cross Hospital, Athens, Greece

    Andromachi Vryonidou

  8. Endocrinology, Department of Sports Science and Wellness, “Parthenope” University Naples, Naples, Italy

    Francesco Orio

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  1. Gerardo Sarno
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Correspondence to Gerardo Sarno.

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Sarno, G., Nappi, R., Altieri, B. et al. Current evidence on vitamin D deficiency and kidney transplant: What’s new?. Rev Endocr Metab Disord 18, 323–334 (2017). https://doi.org/10.1007/s11154-017-9418-z

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Keywords

  • Kidney transplantation
  • Vitamin D
  • Kidney graft survival
  • Cardiovascular disease
  • Bone mineral density
  • Malignancies