肾移植受者移植后循环25-羟基维生素D与长期患者和移植结果的关系:威斯康星同种异体移植受者数据库(WisARD)。

IF 3 Q1 UROLOGY & NEPHROLOGY
Kidney360 Pub Date : 2025-08-07 DOI:10.34067/KID.0000000942
Zhongyu Yuan, Sandesh Parajuli, Didier Mandelbrot, Michal L Melamed, Brad C Astor
{"title":"肾移植受者移植后循环25-羟基维生素D与长期患者和移植结果的关系:威斯康星同种异体移植受者数据库(WisARD)。","authors":"Zhongyu Yuan, Sandesh Parajuli, Didier Mandelbrot, Michal L Melamed, Brad C Astor","doi":"10.34067/KID.0000000942","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Vitamin D inadequacy at or shortly after kidney transplantation is associated with poor outcomes. Circulating 25-hydroxyvitamin D [25(OH)D] levels generally increase over time after transplantation, but inadequacy remains common. Few studies have examined associations of later circulating 25(OH)D levels and long-term outcomes.</p><p><strong>Methods: </strong>We analyzed data from the Wisconsin Allograft Recipient Database to assess the association of post-transplant 25(OH)D with overall graft failure, death-censored graft failure (DCGF), death with a functioning graft (DWFG), cause-specific mortality and eGFR trajectory over the next 4 years.</p><p><strong>Results: </strong>A total of 2504 recipients who maintained a functioning graft for at least 13 months were included in our analysis. A total of 867 overall graft failures occurred during a median follow-up of 6.8 years. Vitamin D deficiency (≤20 ng/ml) was associated with a 43% higher hazard of overall graft failure (95% confidence interval [CI]: 1.16, 1.78), a 2.24-fold higher hazard of DCGF (95% CI: 1.60, 3.12) and a 2.10-fold higher hazard (95% CI: 1.37, 3.21) of infection-related mortality compared with sufficiency. It also was associated with a 1.38 ml/min/1.73m2/year faster (95% CI: -1.97, -0.79) annual eGFR decline compared with sufficiency. No association was detected for DWFG or other cause-specific mortality.</p><p><strong>Conclusions: </strong>In conclusion, post-transplant vitamin D deficiency is associated with a higher risk of DCGF, infection-related mortality and a faster decline of graft function in kidney transplant recipients.</p>","PeriodicalId":17882,"journal":{"name":"Kidney360","volume":" ","pages":""},"PeriodicalIF":3.0000,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Association of Post-transplant Circulating 25-Hydroxyvitamin D and Long-term Patient and Graft Outcomes among Kidney Transplant Recipients: The Wisconsin Allograft Recipient Database (WisARD).\",\"authors\":\"Zhongyu Yuan, Sandesh Parajuli, Didier Mandelbrot, Michal L Melamed, Brad C Astor\",\"doi\":\"10.34067/KID.0000000942\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Vitamin D inadequacy at or shortly after kidney transplantation is associated with poor outcomes. Circulating 25-hydroxyvitamin D [25(OH)D] levels generally increase over time after transplantation, but inadequacy remains common. Few studies have examined associations of later circulating 25(OH)D levels and long-term outcomes.</p><p><strong>Methods: </strong>We analyzed data from the Wisconsin Allograft Recipient Database to assess the association of post-transplant 25(OH)D with overall graft failure, death-censored graft failure (DCGF), death with a functioning graft (DWFG), cause-specific mortality and eGFR trajectory over the next 4 years.</p><p><strong>Results: </strong>A total of 2504 recipients who maintained a functioning graft for at least 13 months were included in our analysis. A total of 867 overall graft failures occurred during a median follow-up of 6.8 years. Vitamin D deficiency (≤20 ng/ml) was associated with a 43% higher hazard of overall graft failure (95% confidence interval [CI]: 1.16, 1.78), a 2.24-fold higher hazard of DCGF (95% CI: 1.60, 3.12) and a 2.10-fold higher hazard (95% CI: 1.37, 3.21) of infection-related mortality compared with sufficiency. It also was associated with a 1.38 ml/min/1.73m2/year faster (95% CI: -1.97, -0.79) annual eGFR decline compared with sufficiency. No association was detected for DWFG or other cause-specific mortality.</p><p><strong>Conclusions: </strong>In conclusion, post-transplant vitamin D deficiency is associated with a higher risk of DCGF, infection-related mortality and a faster decline of graft function in kidney transplant recipients.</p>\",\"PeriodicalId\":17882,\"journal\":{\"name\":\"Kidney360\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.0000,\"publicationDate\":\"2025-08-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Kidney360\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.34067/KID.0000000942\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"UROLOGY & NEPHROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Kidney360","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.34067/KID.0000000942","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
引用次数: 0

摘要

背景:肾移植时或移植后不久维生素D不足与不良预后相关。移植后循环25-羟基维生素D [25(OH)D]水平通常会随着时间的推移而升高,但不足仍然很常见。很少有研究检查后期循环25(OH)D水平与长期预后的关系。方法:我们分析了来自威斯康星州同种异体移植受体数据库的数据,以评估移植后25(OH)D与总体移植物衰竭、死亡审查移植物衰竭(DCGF)、功能移植物死亡(DWFG)、病因特异性死亡率和未来4年eGFR轨迹的关系。结果:在我们的分析中,共纳入了2504例维持移植物功能至少13个月的受者。在平均6.8年的随访期间,总共发生了867例移植失败。维生素D缺乏(≤20 ng/ml)与总体移植物失败的风险增加43%相关(95%可信区间[CI]: 1.16, 1.78), DCGF风险增加2.24倍(95% CI: 1.60, 3.12),感染相关死亡率风险增加2.10倍(95% CI: 1.37, 3.21)。与充足相比,它还与1.38 ml/min/1.73m2/年更快(95% CI: -1.97, -0.79)的年eGFR下降有关。未发现与DWFG或其他原因特异性死亡率相关。结论:总之,移植后维生素D缺乏与肾移植受者更高的DCGF风险、感染相关死亡率和更快的移植功能下降有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Association of Post-transplant Circulating 25-Hydroxyvitamin D and Long-term Patient and Graft Outcomes among Kidney Transplant Recipients: The Wisconsin Allograft Recipient Database (WisARD).

Background: Vitamin D inadequacy at or shortly after kidney transplantation is associated with poor outcomes. Circulating 25-hydroxyvitamin D [25(OH)D] levels generally increase over time after transplantation, but inadequacy remains common. Few studies have examined associations of later circulating 25(OH)D levels and long-term outcomes.

Methods: We analyzed data from the Wisconsin Allograft Recipient Database to assess the association of post-transplant 25(OH)D with overall graft failure, death-censored graft failure (DCGF), death with a functioning graft (DWFG), cause-specific mortality and eGFR trajectory over the next 4 years.

Results: A total of 2504 recipients who maintained a functioning graft for at least 13 months were included in our analysis. A total of 867 overall graft failures occurred during a median follow-up of 6.8 years. Vitamin D deficiency (≤20 ng/ml) was associated with a 43% higher hazard of overall graft failure (95% confidence interval [CI]: 1.16, 1.78), a 2.24-fold higher hazard of DCGF (95% CI: 1.60, 3.12) and a 2.10-fold higher hazard (95% CI: 1.37, 3.21) of infection-related mortality compared with sufficiency. It also was associated with a 1.38 ml/min/1.73m2/year faster (95% CI: -1.97, -0.79) annual eGFR decline compared with sufficiency. No association was detected for DWFG or other cause-specific mortality.

Conclusions: In conclusion, post-transplant vitamin D deficiency is associated with a higher risk of DCGF, infection-related mortality and a faster decline of graft function in kidney transplant recipients.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Kidney360
Kidney360 UROLOGY & NEPHROLOGY-
CiteScore
3.90
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信