The Association of 25-Hydroxyvitamin D Levels with Late Cytomegalovirus Infection in Kidney Transplant Recipients: the Wisconsin Allograft Recipient Database (WisARD)

Transplantation
Brad C AstorMichal L Melamed

Abstract

Cytomegalovirus (CMV) infection is a major cause of morbidity and mortality in kidney transplant recipients. Vitamin D has an integral role in proper immune function, and deficiency is common among kidney transplant recipients. It remains unclear whether 25-hydroxyvitamin D (25(OH)D) level is associated with CMV infection in kidney transplant recipients. We examined the relationship between 25(OH)D levels, measured at least six months post transplant, and subsequent CMV infection in 1,976 recipients free of prior CMV infection. Of 1,976 recipients, 251 (12.7%) were vitamin D deficient [25(OH)D <20 ng/mL] and 548 (27.7%) were insufficient (20-29 ng/mL) at the time of the first 25(OH)D measurement. A total of 107 recipients had a CMV infection within one year of a 25(OH)D measurement. Vitamin D deficiency was associated with a 1.81-fold higher risk (relative hazard=1.81; 95% CI: 1.06, 3.09) that vitamin D sufficiency after adjustment for baseline characteristics and concurrent graft function and blood calcineurin inhibitor concentration. Each 1 ng/mL lower 25(OH)D was associated with a 2% higher risk of infection (95% CI: 0, 4%) in continuous analyses after adjustment. Low 25(OH)D is common in kidney transplant recipients and ass...Continue Reading

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