CLINICS

Clinics (Sao Paulo). 2017 July; 72(7): 415-421.
doi:10.6061/clinics/2017(07)05

Copyright © 2017 CLINICS

Hypovitaminosis D in patients undergoing kidney transplant: the importance of sunlight exposure

Cristiane F. Vilarta I , Marianna D. Unger I , Luciene M. dos Reis I , Wagner V. Dominguez I , Elias David-Neto II , Rosa M. Moysés I III , Silvia Titan I , Melani R. Custodio I , Mariel J. Hernandez IV , Vanda Jorgetti I *

Divisao de Nefrologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR

Divisao de Urologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR

Mestrado em Medicina, Universidade Nove de Julho (UNINOVE), Sao Paulo, SP, BR

Servicio de Nefrología y Trasplante Renal, Hospital Universitario de Caracas, Universidad Central de Venezuela, Caracas, Venezuela

*Corresponding author. E-mail: vandajor@usp.br

received November 24, 2016; revised January 24, 2017; accepted March 14, 2017.

Abstract

OBJECTIVES:

Recent studies have shown a high prevalence of hypovitaminosis D, defined as a serum 25-hydroxyvitamin D level less than 30 ng/ml, in both healthy populations and patients with chronic kidney disease. Patients undergoing kidney transplant are at an increased risk of skin cancer and are advised to avoid sunlight exposure. Therefore, these patients might share two major risk factors for hypovitaminosis D: chronic kidney disease and low sunlight exposure. This paper describes the prevalence and clinical characteristics of hypovitaminosis D among patients undergoing kidney transplant.

METHODS:

We evaluated 25-hydroxyvitamin D serum levels in a representative sample of patients undergoing kidney transplant. We sought to determine the prevalence of hypovitaminosis D, compare these patients with a control group, and identify factors associated with hypovitaminosis D (e.g., sunlight exposure and dietary habits).

RESULTS:

Hypovitaminosis D was found in 79% of patients undergoing kidney transplant, and the major associated factor was low sunlight exposure. These patients had higher creatinine and intact parathyroid hormone serum levels, with 25-hydroxyvitamin D being inversely correlated with intact parathyroid hormone serum levels. Compared with the control group, patients undergoing kidney transplant presented a higher prevalence of 25-hydroxyvitamin D deficiency and lower serum calcium, phosphate and albumin but higher creatinine and intact parathyroid hormone levels.

CONCLUSIONS:

Our results confirmed the high prevalence of hypovitaminosis D in patients undergoing kidney transplant. Therapeutic strategies such as moderate sunlight exposure and vitamin D supplementation should be seriously considered for this population.

Keywords: Vitamin D, Kidney Transplantation, Parathyroid Hormone, Hypovitaminosis D, Chronic Kidney Disease


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