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Kidney Transplants

Kidney transplantation is now a common procedure. End-stage renal disease is the reason for kidney transplantation. Causes of end-stage renal disease include untreated hypertension, infections, diabetes mellitus, and other rarer conditions. Diabetes accounts for one fourth of transplants. The majority of recipients are on dialysis at the time of surgery.

A typical recipient will live up to fifteen years longer after a kidney transplant than if kept on dialysis alone. Transplant tourism is not uncommon, where recipients go to an undeveloped country to buy a kidney from a poverty-stricken donor.

Few people know that kidney function or glomerular filtration rate (GFR) is highly seasonal with wintertime impairment and summertime improvements:

Masugata H et al. Seasonal variation in estimated glomerular filtration rate based on serum creatinine levels in hypertensive patients. Tohoku J Exp Med. 2011;224(2):137-42.

 Doctor Frank Bienaimé, working under senior author Professor Dominique Prié of the Université Paris Descartes in France looked at renal transplantation and vitamin D levels:

Bienaimé F, Girard D, Anglicheau D, Canaud G, Souberbielle JC, Kreis H, Noël LH, Friedlander G, Elie C, Legendre C, Prié D. Vitamin D Status and Outcomes After Renal Transplantation. J Am Soc Nephrol. 2013 Mar 28.

They studied 634 kidney recipients between January 2005 and June 2010. They measured 25(OH)D levels three months after surgery and followed the patients for an average of 4 years. Mean vitamin D levels at 3 months were low, 13 ng/ml, and less than 30 ng/ml in 92% of patients.

The authors found no association between 25(OH)D and survival or transplant rejections, but they did find significant independent associations of lower 25(OH)D levels with lower measured GFR at 12 months (P=0.001) and higher risk for interstitial fibrosis and tubular atrophy (P=0.01). To my knowledge, this was the first study to link vitamin D status with functional renal outcomes in such patients.

by Dr John Cannell

Hippocrates Natural Vitamin D3 is available.