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Vitamin D deficiency, endothelial function and bone biomarkers in post-kidney transplantation patients from North India.

Yadav, AK; Tiwana, S; Steel, M; Ramachandran, R; Kaski, JC; Jha, V; Banerjee, D (2019) Vitamin D deficiency, endothelial function and bone biomarkers in post-kidney transplantation patients from North India. Int Urol Nephrol, 51 (1). pp. 181-186. ISSN 1573-2584 https://doi.org/10.1007/s11255-018-2014-7
SGUL Authors: Banerjee, Debasish

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Abstract

PURPOSE: CKD patients after kidney transplantation continue to suffer from elevated CV events which may be related to low vitamin D and its adverse impact on vascular function. The prevalence of vitamin D deficiency in North Indian kidney transplantation patients and its impact on vascular and bone biomarkers is unknown which this study investigated. METHODS: Non-diabetic, stable, > 6 months post-kidney transplantation patients, not on vitamin D supplementation, were recruited after informed consent. Data on demographics, anthropometrics and treatment were collected. Blood samples were stored at - 80 °C until analysis for bone and endothelial cell biomarkers using standard ELISA techniques. RESULTS: The clinical characteristics were: age 37.4 ± 9.9 years, 80% men, 27% ex-smokers, BP 125.5 ± 15.7/78.6 ± 9.7 mmHg, cholesterol 172.0 ± 47.8 mg/dL, hemoglobin 12.6 ± 2.3 g/dL, calcium 9.5 ± 0.6 mg/d and iPTH 58.4 ± 32.9 ng/mL and vitamin D 36.5 ± 39.8 nmol/L. Patients with vitamin D < 37.5 nmol/L (66%) had similar age, serum creatinine, serum phosphate, iPTH, blood pressure but lower calcium (9.3 ± 0.7 vs. 9.6 ± 0.5 mg/dL; p = 0.024), lower FGF23 (median 18.8 vs. 80.0 pg/mL; p = 0.013) and higher E-selectin (15.8 ± 7.9 vs. 13.0 ± 5.5 ng/mL; p = 0.047). On Univariate analysis, E-selectin (r = - 0.292; p = 0.005), FGF23 (r = 0.217; p = 0.036) and calcium (r = 0.238; p = 0.022) were significantly correlated with vitamin D levels. On stepwise multiple regression analysis, only E-selectin was associated with vitamin D levels (β = - 0.324; p = 0.002). CONCLUSION: Vitamin D deficiency was common in kidney transplant recipients in North India, associated with low FGF23 and high E-selectin. These findings suggest further investigations to assess the role of vitamin D deficiency-associated endothelial dysfunction, its implications and reversibility in kidney transplantation recipients.

Item Type: Article
Additional Information: © The Author(s) 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
Keywords: Cardiovascular, Endothelial dysfunction, Fibroblast growth factor 23, Kidney transplantation, Vitamin D, 1103 Clinical Sciences, Urology & Nephrology
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: Int Urol Nephrol
ISSN: 1573-2584
Language: eng
Dates:
DateEvent
January 2019Published
19 November 2018Published Online
19 October 2018Accepted
Publisher License: Creative Commons: Attribution 4.0
PubMed ID: 30456544
Go to PubMed abstract
URI: http://openaccess.sgul.ac.uk/id/eprint/110428
Publisher's version: https://doi.org/10.1007/s11255-018-2014-7

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