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Endocrine
Published in: Endocrine 3/2015

01-12-2015 | Mini Review

The impact of vitamin D deficiency on patients undergoing kidney transplantation: focus on cardiovascular, metabolic, and endocrine outcomes

Authors: Gerardo Sarno, Giuseppe Daniele, Giacomo Tirabassi, Alberto O. Chavez, Opeolu O. Ojo, Francesco Orio, Hana Kahleova, Giancarlo Balercia, William B. Grant, Paride De Rosa, Annamaria Colao, Giovanna Muscogiuri

Published in: Endocrine | Issue 3/2015

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Abstract

Vitamin D deficiency is common among kidney transplant (KT) recipients because of reduced sunlight exposure, low intake of vitamin D, the immunosuppressive drug regimen administered, and steroid therapy. Glucocorticoids regulate expression of genes coding for enzymes that catabolize vitamin D, further reducing its level in serum. Although vitamin D primarily regulates calcium homeostasis, vitamin D deficiency is associated with the risk of several diseases, such as diabetes mellitus and tuberculosis. Aim of this review is to highlight endocrine and metabolic alterations due to the vitamin D deficiency by evaluating the mechanisms involved in the development of KT-related disease (cardiovascular, bone mineral density, and new-onset diabetes after transplantation). Next, we review evidence to support a link between low vitamin D status and KT-related diseases. Finally, we briefly highlight strategies for restoring vitamin D status in KT patients.
Literature
1.
2.
G. Muscogiuri, G. Tirabassi, G. Bizzaro, F. Orio, S.A. Paschou, A. Vryonidou, G. Balercia, Y. Shoenfeld, A. Colao, Vitamin D and thyroid disease: to D or not to D? Eur. J. Clin. Nutr. (2014). doi:10.​1038/​ejcn.​2014.​265 PubMed
3.
H. Taskapan, M. Wei, D.G. Oreopoulos, 25(OH) vitamin D3 in patients with chronic kidney disease and those on dialysis: rediscovering its importance. Int. Urol. Nephrol. 38, 323–329 (2006)CrossRefPubMed
4.
E.A. González, A. Sachdeva, D.A. Oliver, K.J. Martin, Vitamin D insufficiency and deficiency in chronic kidney disease. A single center observational study. Am. J. Nephrol. 24, 503–510 (2004)CrossRefPubMed
5.
6.
A. Stavroulopoulos, M.J. Cassidy, C.J. Porter, D.J. Hosking, S.D. Roe, Vitamin D status in renal transplant recipients. Am. J. Transpl. 7, 2546–2552 (2007)CrossRef
7.
C.C. Hesketh, G.A. Knoll, A.O. Molnar, A. Tsampalieros, D.L. Zimmerman, Vitamin D and kidney transplant outcomes: a protocol for a systematic review and meta-analysis. Syst. Rev. 3, 64 (2014)PubMedCentralCrossRefPubMed
8.
C.T. Lee, H.Y. Ng, Y.H. Lien, L.W. Lai, M.S. Wu, C.R. Lin, H.C. Chen, Effects of cyclosporine, tacrolimus and rapamycin on renal calcium transport and vitamin D metabolism. Am. J. Nephrol. 34, 87–94 (2011)CrossRefPubMed
9.
J.M. Pascussi, A. Robert, M. Nguyen, O. Walrant-Debray, M. Garabedian, P. Martin, T. Pineau, J. Saric, F. Navarro, P. Maurel, M.J. Vilarem, Possible involvement of pregnane X receptor-enhanced CYP24 expression in drug-induced osteomalacia. J. Clin. Investig. 115, 177–186 (2005)PubMedCentralCrossRefPubMed
10.
D.M. Sadlier, C.C. Magee, Prevalence of 25(OH) vitamin D (calcidiol) deficiency at time of renal transplantation: a prospective study. Clin. Transplant. 21, 683–688 (2007)PubMed
11.
S.S. Tripathi, E.M. Gibney, T.W. Gehr, A.L. King, M.J. Beckman, High prevalence of vitamin D deficiency in African American kidney transplant recipients. Transplantation 85, 767–770 (2008)CrossRefPubMed
12.
J.A. Riancho, A.L. de Francisco, C. del Arco, J.A. Amado, J.G. Cotorruelo, M. Arias, J. Gonzalez-Macias, Serum levels of 1,25-dihydroxyvitamin D after renal transplantation. Miner. Electrolyte Metab. 14, 332–337 (1988)PubMed
13.
X. Barros, D. Fuster, N. Rodríguez, L. Rodas, M.J. Martínez-Osaba, J.M. Campistol, D. Rubello, P.M. Colletti, F. Campos, F. Pons, J.V. Torregrosa, Rapid calcitriol increase and persistent calcidiol insufficiency in the first 6 months after kidney transplantation. Nucl. Med. Commun. (2015). doi:10.​1097/​MNM.​0000000000000265​
14.
R. Levi, J. Silver, Vitamin D supplementation after renal transplantation: how much vitamin D should we prescribe? Kidney Int. 75, 576–578 (2009)CrossRefPubMed
15.
M. Courbebaisse, J.C. Souberbielle, E. Thervet, Potential nonclassical effects of vitamin D in transplant recipients. Transplantation 89, 131–137 (2010)CrossRefPubMed
16.
R. McGregor, G. Li, H. Penny, G. Lombardi, B. Afzali, D.J. Goldsmith, Vitamin D in renal transplantation—from biological mechanisms to clinical benefits. Am. J. Transplant. 14, 1259–1270 (2014)PubMedCentralCrossRefPubMed
17.
J. Bacchetta, S. Pelletier, G. Jean, D. Fouque, Immune, metabolic and epidemiological aspects of vitamin D in chronic kidney disease and transplant patients. Clin. Biochem. 47, 509–515 (2014)CrossRefPubMed
18.
C. Ponticelli, G. Sala, Vitamin D: a new player in kidney transplantation? Expert. Rev. Clin. Immunol. 10, 1375–1383 (2014)CrossRefPubMed
19.
A.O. Ojo, Cardiovascular complications after renal transplantation and their prevention. Transplantation 82, 603–611 (2006)CrossRefPubMed
20.
S. Aakhus, K. Dahl, T.E. Widerøe, Cardiovascular disease in stable renal transplant patients in Norway: morbidity and mortality during a 5-yr follow-up. Clin. Transplant. 18, 596–604 (2004)CrossRefPubMed
21.
E.M. Dimény, Cardiovascular disease after renal transplantation. Kidney Int. Suppl. 61, 78–84 (2002)CrossRef
22.
T.J. Wang, M.J. Pencina, S.L. Booth, P.F. Jacques, E. Ingelsson, K. Lanier, E.J. Benjamin, R.B. D’Agostino, M. Wolf, R.S. Vasan, Vitamin D deficiency and risk of cardiovascular disease. Circulation 117, 503–511 (2008)CrossRefPubMed
23.
C.A. Keyzer, I.J. Riphagen, M.M. Joosten, G. Navis, A.C. Muller Kobold, I.P. Kema, S.J. Bakker, M.H. de Borst, NIGRAM consortium, Associations of 25(OH) and 1,25(OH)2 Vitamin D with long-term outcomes in stable renal transplant recipients. J. Clin. Endocrinol. Metab. 100, 81–89 (2015)CrossRefPubMed
24.
J.L. Vacek, S.R. Vanga, M. Good, S.M. Lai, D. Lakkireddy, P.A. Howard, Vitamin D deficiency and supplementation and relation to cardiovascular health. Am. J. Cardiol. 109, 359–363 (2012)CrossRefPubMed
25.
D. Somjen, Y. Weisman, F. Kohen, B. Gayer, R. Limor, O. Sharon, N. Jaccard, E. Knoll, N. Stern, 25-hydroxyvitamin D3-1alpha-hydroxylase is expressed in human vascular smooth muscle cells and is upregulated by parathyroid hormone and estrogenic compounds. Circulation 111, 1666–1671 (2005)CrossRefPubMed
26.
K.L. Jablonski, M. Chonchol, G.L. Pierce, A.E. Walker, D.R. Seals, 25-Hydroxyvitamin D deficiency is associated with inflammation-linked vascular endothelial dysfunction in middle-aged and older adults. Hypertension 57, 63–69 (2011)PubMedCentralCrossRefPubMed
27.
L. Wang, J.E. Manson, Y. Song, H.D. Sesso, Systematic review: vitamin D and calcium supplementation in prevention of cardiovascular events. Ann. Intern. Med. 152, 315–323 (2010)CrossRefPubMed
28.
G. Sarno, G. Muscogiuri, P. De Rosa, New-onset diabetes after kidney transplantation: prevalence, risk factors, and management. Transplantation 93, 1189–1195 (2012)CrossRefPubMed
29.
G. Sarno, R.J. Mehta, R. Guardado-Mendoza, L.M. Jimenez-Ceja, P. De Rosa, G. Muscogiuri, New-onset diabetes mellitus: predictive factors and impact on the outcome of patients undergoing liver transplantation. Curr. Diabetes Rev. 9, 78–85 (2013)CrossRefPubMed
30.
A.R. Gosmanov, S. Dagogo-Jack, Predicting, managing and preventing new-onset diabetes after transplantation. Minerva Endocrinol. 37, 233–246 (2012)PubMed
31.
P.T. Pham, P.M. Pham, S.V. Pham, P.A. Pham, P.C. Pham, New onset diabetes after transplantation (NODAT): an overview. Diabetes Metab. Syndr. Obes. 4, 175–186 (2011)PubMedCentralCrossRefPubMed
32.
S. Lee, S.A. Clark, R.K. Gill, S. Christakos, 1,25-Dihydroxyvitamin D3 and pancreatic beta-cell function: vitamin D receptors, gene expression, and insulin secretion. Endocrinology 134, 1602–1610 (1994)PubMed
33.
S. Ghavamzadeh, M. Mobasseri, R. Mahdavi, The effect of vitamin D supplementation on adiposity, blood glycated hemoglobin, serum leptin and tumor necrosis factor-α in type 2 diabetic patients. Int. J. Prev. Med. 5, 1091–1098 (2014)PubMedCentralPubMed
34.
E.O. Gosmanova, V. Tangpricha, A.R. Gosmanov, Endocrine-metabolic pathophysiologic conditions and treatment approaches after kidney transplantation. Endocr. Pract. 18, 579–590 (2012)CrossRefPubMed
35.
S. Abbas, J. Linseisen, S. Rohrmann, J.W. Beulens, B. Buijsse, P. Amiano, E. Ardanaz, B. Balkau, H. Boeing, F. Clavel-Chapelon, G. Fagherazzi, P.W. Franks, D. Gavrila, S. Grioni, R. Kaaks, T.J. Key, K.T. Khaw, T. Kühn, A. Mattiello, E. Molina-Montes, P.M. Nilsson, K. Overvad, J.R. Quirós, O. Rolandsson, C. Sacerdote, C. Saieva, N. Slimani, I. Sluijs, A.M. Spijkerman, A. Tjonneland, R. Tumino, D.L. van der A, R. Zamora-Ros, S.J. Sharp, C. Langenberg, N.G. Forouhi, E. Riboli, N.J. Wareham, Dietary vitamin D intake and risk of type 2 diabetes in the European prospective investigation into cancer and nutrition: the EPIC-interact study. Eur. J. Clin. Nutr. 68, 196–202 (2014)PubMedCentralCrossRefPubMed
36.
M. Courbebaisse, C. Alberti, S. Colas, D. Prié, J.C. Souberbielle, J.M. Treluyer, E. Thervet, VITamin D supplementation in renAL transplant recipients (VITALE): a prospective, multicentre, double-blind, randomized trial of vitamin D estimating the benefit and safety of vitamin D3 treatment at a dose of 100,000 UI compared with a dose of 12,000 UI in renal transplant recipients: study protocol for a double-blind, randomized, controlled trial. Trials 15, 430 (2014)PubMedCentralCrossRefPubMed
37.
B.A. Julian, D.A. Laskow, J. Dubovsky, E.V. Dubovsky, J.J. Curtis, L.D. Quarles, Rapid loss of vertebral mineral density after renal transplantation. N. Engl. J. Med. 325, 544–550 (1996)CrossRef
38.
R.J. Weisinger, R.G. Carlini, E. Rojas, E. Bellorin-Font, Bone disease after renal transplantation. Clin. J. Am. Soc. Nephrol. 1, 1300–1313 (2006)CrossRefPubMed
39.
R.G. De Sévaux, A.J. Hoitsma, F.H. Corstens, J.F. Wetzels, Treatment with vitamin D and calcium reduces bone loss after renal transplantation: a randomized study. J. Am. Soc. Nephrol. 13, 1608–1614 (2002)CrossRefPubMed
40.
T.J. Weber, L.D. Quarles, Preventing bone loss after renal transplantation with bisphosphonates: we can… but should we? Kidney Int. 57, 735–737 (2000)CrossRefPubMed
41.
M. Talalaj, L. Gradowska, E. Marcinowska-Suchowierska, M. Durlik, Z. Gaciong, M. Lao, Efficiency of preventive treatment of glucocorticoid-induced osteoporosis with 25-hydroxyvitamin D3 and calcium in kidney transplant patients. Transplant. Proc. 28, 3485–3487 (1996)PubMed
42.
A.E. El-Agroudy, A.A. El-Husseini, M. El-Sayed, T. Mohsen, M.A. Ghoneim, A prospective randomized study for prevention of post renal transplantation bone loss. Kidney Int. 67, 2039–2045 (2005)CrossRefPubMed
43.
A. Ugur, N. Guvener, I. Isiklar, H. Karakayali, R. Erdal, Efficiency of preventive treatment for osteoporosis after renal transplantation. Transplant. Proc. 32, 556–557 (2000)CrossRefPubMed
44.
J.R. Jeffery, W.D. Leslie, M.E. Karpinski, P.W. Nickerson, D.N. Rush, Prevalence and treatment of decreased bone density in renal transplant recipients: a randomized prospective trial of calcitriol versus alendronate. Transplantation 76, 1498–1502 (2003)CrossRefPubMed
45.
A.E. El-Agroudy, A.A. El-Husseini, M. El-Sayed, M.A. Ghoneim, Preventing bone loss in renal transplant recipients with vitamin D. J. Am. Soc. Nephrol. 14, 2975–2979 (2003)CrossRefPubMed
46.
A. Torres, S. Garcia, A. Gomez, A. Gonzalez, Y. Barrios, M.T. Concepcion, D. Hernandez, J.J. Garcia, M.D. Checa, V. Lorenzo, E. Salido, Treatment with intermittent calcitriol and calcium reduces bone loss after renal transplantation. Kidney Int. 65, 705–712 (2004)CrossRefPubMed
47.
B.L. Kasiske, M.G. Zeier, J.R. Chapman, J.C. Craig, H. Ekberg, C.A. Garvey, M.D. Green, V. Jha, M.A. Josephson, B.A. Kiberd, H.A. Kreis, R.A. McDonald, J.M. Newmann, G.T. Obrador, F.G. Vincenti, M. Cheung, A. Earley, G. Raman, S. Abariga, M. Wagner, E.M. Balk, Kidney disease: improving global outcomes. KDIGO clinical practice guideline for the care of kidney transplant recipients: a summary. Kidney Int. 77, 299–311 (2010)CrossRefPubMed
48.
Y. Obi, N. Ichimaru, T. Hamano, K. Tomida, I. Matsui, N. Fujii, M. Okumi, J.Y. Kaimori, K. Yazawa, Y. Kokado, Y. Tsubakihara, N. Nonomura, H. Rakugi, S. Takahara, Y. Isaka, Orally active vitamin D for potential chemoprevention of posttransplant malignancy. Cancer Prevent. Res. (Phila) 5, 1229–1235 (2012)CrossRef
49.
K.M. Wissing, N. Broeders, R. Moreno-Reyes, C. Gervy, B. Stallenberg, D. Abramowicz, A controlled study of vitamin D3 to prevent bone loss in renal-transplant patients receiving low doses of steroids. Transplantation 79, 108–115 (2005)CrossRefPubMed
50.
J.K. Berga, J.C. Albiach, S.B. Catalan, E.G. Martinez, A.S. Calabuig, A.A. Bernabeu, L.M.P. Mateu, Vitamin D deficiency in a renal transplant population: safe repletion with moderate doses of calcidiol. Transplant. Proc. 42, 2917–2920 (2010)CrossRef
51.
M. Courbebaisse, E. Thervet, J.C. Souberbielle, J. Zuber, D. Eladari, F. Martinez, M.F. Mamzer-Bruneel, P. Urena, C. Legendre, G. Friedlander, D. Prié, Effects of vitamin D supplementation on the calcium-phosphate balance in renal transplant patients. Kidney Int. 75, 646–651 (2009)CrossRefPubMed
52.
U. Thiem, G. Heinze, R. Segel, T. Perkmann, F. Kainberger, F. Mühlbacher, W. Hörl, K. Borchhardt, VITA-D: cholecalciferol substitution in vitamin D deficient kidney transplant recipients: a randomized, placebo-controlled study to evaluate the posttransplant outcome. Trials 10, 36 (2009)PubMedCentralCrossRefPubMed
53.
T. Yasuda, Y. Okamoto, N. Hamada, K. Miyashita, M. Takahara, F. Sakamoto, T. Miyatsuka, T. Kitamura, N. Katakami, D. Kawamori, M. Otsuki, T.A. Matsuoka, H. Kaneto, I. Shimomura, Serum vitamin D levels are decreased in patients without remission of Graves’ disease. Endocrine 43, 230–232 (2013)PubMedCentralCrossRefPubMed
54.
A. Colao, G. Muscogiuri, M. Rubino, L. Vuolo, C. Pivonello, P. Sabatino, M. Pizzo, G. Campanile, R. Fittipaldi, G. Lombardi, C. Di Somma, Hypovitaminosis D in adolescents living in the land of sun is correlated with incorrect life style: a survey study in Campania region. Endocrine (2014). doi:10.​1007/​s12020-014-0483-8
55.
N. Sharifi, R. Amani, E. Hajiani, B. Cheraghian, Does vitamin D improve liver enzymes, oxidative stress, and inflammatory biomarkers in adults with non-alcoholic fatty liver disease? A randomized clinical trial. Endocrine 47, 70–80 (2014)CrossRefPubMed
56.
M. Redzic, D.K. Powell, D.T. Thomas, Vitamin D status is related to intramyocellular lipid in older adults. Endocrine 47, 854–861 (2014)CrossRefPubMed
57.
58.
R.H. Chen, X.H. Zhao, Z. Gu, P.L. Gu, B. Zhou, Z.H. Zhu, L.Y. Xu, Y.F. Zou, X.Z. Jiang, Serum levels of 25-hydroxyvitamin D are associated with cognitive impairment in type 2 diabetic adults. Endocrine 45, 319–324 (2014)CrossRefPubMed
Metadata
Title
The impact of vitamin D deficiency on patients undergoing kidney transplantation: focus on cardiovascular, metabolic, and endocrine outcomes
Authors
Gerardo Sarno
Giuseppe Daniele
Giacomo Tirabassi
Alberto O. Chavez
Opeolu O. Ojo
Francesco Orio
Hana Kahleova
Giancarlo Balercia
William B. Grant
Paride De Rosa
Annamaria Colao
Giovanna Muscogiuri
Publication date
01-12-2015
Publisher
Springer US
Published in
Endocrine / Issue 3/2015
Print ISSN: 1355-008X
Electronic ISSN: 1559-0100
DOI
https://doi.org/10.1007/s12020-015-0632-8

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