Abstract: SA-PO995
Association of Post-transplant 25-Hydroxyvitamin D and Infection in Kidney Transplant Recipients
Session Information
- Transplantation: Clinical - 4
October 26, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Yuan, Zhongyu, University of Wisconsin-Madison Department of Population Health Sciences, Madison, Wisconsin, United States
- Melamed, Michal L., NYU Langone Health, New York, New York, United States
- Jorgenson, Margaret R., UW Health, Madison, Wisconsin, United States
- Mandelbrot, Didier A., University of Wisconsin-Madison Department of Medicine, Madison, Wisconsin, United States
- Parajuli, Sandesh, University of Wisconsin-Madison Department of Medicine, Madison, Wisconsin, United States
- Astor, Brad C., University of Wisconsin-Madison Department of Population Health Sciences, Madison, Wisconsin, United States
Background
Infection is a leading cause of morbidity and mortality in kidney transplant recipients (KTRs). There is a growing interest in the immunoregulatory effect of vitamin D. While vitamin D inadequacy is common among KTRs, the association of serum 25-hydroxyvitamin D [25(OH)D] and infection remains unclear.
Methods
KTRs with at least one serum 25(OH)D measurement from 5 to13 months after transplant at our center from 2005 to 2020 were included. All 25(OH)D measurements thereafter were included as a time-varying variable. Infections within 365 days of each 25(OH)D measurement were identified. Marginal rates models were fitted to account for multiple infection episodes for each KTR. Models adjusted for recipient age, sex, race, cause of kidney failure, donor status, delayed graft function, prior kidney transplant, human leukocyte antigen-mismatch, immunosuppression, infection and acute rejection history, transplant year, season of 25(OH)D measurement, serum albumin, proteinuria and estimated glomerular filtration rate.
Results
A total of 2251 infection episodes were identified in 2207 KTRs followed for a median of 6.6 years after transplant. 23% and 10% of KTRs had vitamin D insufficiency (21-29ng/ml) and deficiency (≤ 20ng/ml), respectively, at baseline. Vitamin D deficiency was associated with a 1.22-fold (adjusted rate ratio [aRR]=1.22; 95%CI: 1.03-1.43; p=0.02) higher incidence of infection compared with vitamin D sufficiency. The association was strongest for bacterial infection (aRR=1.40; 95%CI: 1.14-1.73; p<0.01), especially urinary tract infection (aRR=1.55; 95%CI: 1.24-1.94; p<0.01).
Conclusion
Vitamin D deficiency is independently associated with a higher incidence of infection in KTRs, especially urinary tract infection. Further research is needed to determine the causal relationship.