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. 2020 Nov;24(7):e13809.
doi: 10.1111/petr.13809. Epub 2020 Aug 26.

Association between 25(OH) vitamin D and graft survival in renal transplanted children

Mélodie Mosca  1   2 , Mathilde Lion-Lambert  3   4 , Frank Bienaimé  4   5   6 , Romain Berthaud  3   4   7 , Guillaume Dorval  3   4   7 , Nicolas Garcelon  7 , Laurène Dehoux  3 , Saoussen Krid  3 , Marina Charbit  3 , Marion Rabant  8 , Patrick Niaudet  3   4 , Rémi Salomon  3   4   7 , Justine Bacchetta  1   2   9 , Olivia Boyer  3   4   7
Affiliations

Association between 25(OH) vitamin D and graft survival in renal transplanted children

Mélodie Mosca et al. Pediatr Transplant. 2020 Nov.

Abstract

Background: In children, vitamin D deficiency is common after renal transplantation. Besides promoting bone and muscle development, vitamin D has immunomodulatory effects, which could protect kidney allografts. The purpose of this study was to assess the association between vitamin D status and the occurrence of renal rejection.

Methods: We studied a retrospective cohort of 123 children, who were transplanted at a single institution between September 2008 and April 2019. Patients did not receive vitamin D supplementation systematically. In addition, factors influencing vitamin D status were analyzed using univariate and multivariate analyses.

Results: Median 25-hydroxy-vitamin D (25-OH-D) concentration was close to reference values at the time of transplantation (30 ng/mL (min-max 5-100)), but rapidly decreased within the first 3 months to 19 ng/mL (min-max 3-91) (P < .001). The overall acute rejection rate was 7%. The clinical rejection rate (5% vs 9%), subclinical rejection (12% vs 36%), and borderline changes (21% vs 28%) were not statistically different during the follow-up between the 3-month 25-OH-D < 20 ng/mL and 3-month 25-OH-D > 20 ng/mL groups. There was a correlation between the 25-OH-D levels and PTH concentration at 3 months (r = -.2491, P = .01), but no correlation between the 3-month 25-OH-D and the season of the year (F = 0.19, P = .90; F = 1.34, P = .27, respectively). Multivariate analyses revealed that age and mGFR at 3 months, were independent predictors of mGFR at 12 months.

Conclusion: Our data show that vitamin D deficiency can develop rapidly after transplantation; vitamin D levels at 3 months are not associated with lower mGFR or a higher rejection rate at 1 year in children as opposed to adult recipients.

Keywords: allograft; pediatric; rejection; transplantation; vitamin D.

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References

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