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Review
. 2017 May 27;9(6):550.
doi: 10.3390/nu9060550.

Nutritional Vitamin D in Renal Transplant Patients: Speculations and Reality

Piergiorgio Messa  1   2 , Anna Regalia  3 , Carlo Maria Alfieri  4
Affiliations
Review

Nutritional Vitamin D in Renal Transplant Patients: Speculations and Reality

Piergiorgio Messa et al. Nutrients. .

Abstract

Reduced levels of nutritional vitamin D are commonly observed in most chronic kidney disease (CKD) patients and particularly in patients who have received a kidney transplant (KTx). In the complex clinical scenario characterizing the recipients of a renal graft, nutritional vitamin D deficiency has been put in relation not only to the changes of mineral and bone metabolism (MBM) after KTx, but also to most of the medical complications which burden KTx patients. In fact, referring to its alleged pleiotropic (non-MBM related) activities, vitamin D has been claimed to play some role in the occurrence of cardiovascular, metabolic, immunologic, neoplastic and infectious complications commonly observed in KTx recipients. Furthermore, low nutritional vitamin D levels have also been connected with graft dysfunction occurrence and progression. In this review, we will discuss the purported and the demonstrated effects of native vitamin D deficiency/insufficiency in most of the above mentioned fields, dealing separately with the MBM-related and the pleiotropic effects.

Keywords: CKD; VDR; calcifediol; renal transplantation; vitamin D.

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Conflict of interest statement

No conflict of interest related to the present paper is declared.

Figures

Figure 1
Figure 1
Suggested “non-mineral and bone metabolism (MBM) related” effects of native vitamin D which could play a beneficial role on the main clinical complications which occur in kidney transplant (KTx) patients. RAS = renin angiotensin system.
Figure 2
Figure 2
Main factors contributing to the development of chronic renal allograft dysfunction. The darker boxes represent mechanisms on which vitamin D status could play some counteracting role. ABMR = antibody mediated rejection; BKV = BK virus; CMV = cyomegalovirus; CNI = calcineurin inhibitors; GN = glomerulonephritis; IF/TA = interstitial fibrosis/ tubular atrophy; HCV = hepatitis C virus; MS = metabolic syndrome; NSAID = non steroid anti-inflammatory drugs; PSHP = persistent secondary hyperparathyroidism; TCMR = T-cell mediated rejection; UTI = urinary tract infections.
See this image and copyright information in PMC

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