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. 2021 Apr 30;51(2):802-812.
doi: 10.3906/sag-1911-156.

Vitamin D receptor polymorphisms and bone health after kidney transplantation

Berfu Korucu  1 , Ajlan Tükün  2 , Özant Helvacı  1 , Hasan Yeter  1 , Sevim Gönen  3 , Galip Güz  1 , Turgay Arınsoy  1
Affiliations

Vitamin D receptor polymorphisms and bone health after kidney transplantation

Berfu Korucu et al. Turk J Med Sci. .

Abstract

Background/aim: Bone disease is one of the most prominent complications after kidney transplantation. Bone diseases include osteoporosis, persistent secondary hyperparathyroidism, and avascular necrosis (AVN). We investigated the relationship between the polymorphisms of the vitamin D receptor (VDR) gene and bone diseases occurring after kidney transplantation.

Materials and methods: The study consists of 234 kidney allograft recipients with a minimum follow-up of five years after kidney transplantation. Patients with glomerular filtration rates less than 30 mL/min/1.73m2, a history of parathyroidectomy, bisphosphonate use pre- or post-transplantation, and cinacalcet use posttransplantation excluded. We evaluated associations between the polymorphisms of the VDR gene (BsmI, TaqI, ApaI, FokI, and Cdx2), the first-year bone mineral density (BMD) scores, persistent secondary hyperparathyroidism, and AVN.

Results: Patients with low BMD scores were significantly younger (P = 0.03) and had higher intact parathormone (iPTH) levels (P = 0.03). Cdx2 TT genotype significantly increases the risk of low BMD scores (OR: 3.34, P = 0.04). Higher phosphate levels were protective against abnormal BMD scores (OR: 0.53; P = 0.03). Patients with persistent hyperparathyroidism had significantly longer dialysis vintage and higher pretransplantation iPTH levels (P = 0.02 and P < 0.001, respectively). Cdx2, CT/TT, and ApaI CA/AA genotypes significantly increase the risk of persistent hyperparathyroidism (OR: 6.81, P < 0.001, OR: 23.32, P < 0.001, OR:4.01, P = 0.02, and OR: 6.30, P = 0.01; respectively). BsmI CT/TT genotypes were found to increase AVN risk with an HR of 3.48 (P = 0.03). Higher hemoglobin levels were also found to decrease AVN risk with an HR of 0.76 (P = 0.05).

Conclusion: Certain VDR gene polymorphisms are associated with a higher risk for bone diseases after kidney transplantation.

Keywords: Kidney transplantation; VDR polymorphisms; osteoporosis; avascular necrosis; persistent hyperparathyroidism.

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Conflict of interest statement

The authors declare no conflicts of interest.

References

    1. Wolfe RA Ashby VB Milford EL Ojo AO Ettenger RE Comparison of mortality in all patients on dialysis, patients on dialysis awaiting transplantation, and recipients of a first cadaveric transplant. New England Journal of Medicine . 1999;341:1725–1730. - PubMed
    1. Hruska KA Teitelbaum SL Renal osteodystrophy. New England Journal of Medicine . 1995;333:166–175. - PubMed
    1. Dounousi E Leivaditis K Eleftheriadis T Liakopoulos V Osteoporosis after renal transplantation. International Urology and Nephrology . 2015;47:503–511. - PubMed
    1. Park W Han S Choi B Park C Yang C Progression of osteoporosis after kidney transplantation in patients with end-stage renal disease. Transplantation . 2017;Proceedings2017:1033–1037. - PubMed
    1. Cunningham J Posttransplantation bone disease. Transplantation . 2005;79:629–634. - PubMed

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