Vitamin D Levels and the Risk of Posttransplant Diabetes Mellitus After Kidney Transplantation.
Kevin Quach, Monica Abdelmasih, Pei Xuan Chen and 7 others
PMID 33789542WHAT IT FOUND
Lower pre-transplant vitamin D was linked to more post-transplant diabetes in kidney recipients, but not every analysis showed a clear difference.
Key findings
01A 10 nmol/L lower pre-transplant 25(OH)D was associated with higher PTDM risk (HR 1.06, 95% CI 1.01, 1.13).
02By clinical vitamin D categories, the replete group (>=75 nmol/L) had 12-month PTDM probability 17.9%, compared with 22.7% (<40 nmol/L) and 25.5% (40 to 74.9 nmol/L), but the category comparison had log-rank P = 0.051.
03In quartile analysis, the highest vitamin D group had 12-month PTDM probability 15.6%, and the three lower quartile groups had PTDM hazard ratios 1.85, 2.01, and 1.77 compared with the highest group.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The final analysed cohort was 442 patients, and 411 patients were excluded because samples were insufficient for vitamin D measurement. The analysed cohort differed from the total eligible population of 1519: fewer males (55.7% vs 62.6%), longer median dialysis time (4.9 vs 3.7 years), and less depleting induction therapy (52.8% vs 60.7%). The lowest vitamin D group had only 97 patients, which may make its estimates less precise. Vitamin D was measured from samples taken within one year before transplant, not necessarily at transplant, so levels could have changed. The association was not statistically significant in every analysis, so the strength of the finding varies by how vitamin D was grouped. Because this was an observational study, it cannot show that raising vitamin D prevents post-transplant diabetes.
Declared interests
The authors declared no potential conflicts of interest.
The easy way to misread this
Do not conclude that vitamin D supplementation prevents post-transplant diabetes. This study measured vitamin D levels before transplant, not a treatment, and some analyses did not show a clear difference.