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Negin Mozafarmoghadam 
, Asghar Zarban , Zeinab Saremi , Gholamreza Sharifzadeh , Vajehallah Raeesi *
, Asghar Zarban , Zeinab Saremi , Gholamreza Sharifzadeh , Vajehallah Raeesi *
Department of Internal Medicine, School of Medicine, Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
Abstract: (22 Views)
Introduction: Chronic Kidney Disease (CKD) is associated with mineral metabolism disorders, such as calcium, phosphorus, and calcium-regulating hormones. Moreover, the need to prescribe and use corticosteroid compounds increases the risk of osteoporosis in these patients. Therefore, this study aimed to investigate the serum level of Vitamin D and its relationship with osteoporosis in kidney transplant patients (KTPs) in Birjand, Iran.
Methods: This descriptive-analytical cross-sectional study included 50 KTPs in Birjand, Iran, who had passed at least one year after a kidney transplant. Vitamin D serum level and bone mineral density (BMD) were measured by the Dual-Energy X-Ray Absorptiometry method. Data analysis was done using SPSS software (version 19) and statistical tests, such as Fisher's exact test, chi-square, independent samples t-test, and Pearson correlation coefficient at α=0.05 level.
Results: Vitamin D level showed no significant relationship with BMD, T score, and Z score. The mean of Z SPINE, Z RAD, T SPINE, T HIP, and T RAD in women was significantly higher than that of men (P<0.05). Moreover, no statistically significant linear correlation of vitamin D levels was observed with T-score and Z-score indices according to age in the studied patients. Finally, the results showed no significant relationship of Vitamin D levels with BMD, T score, and Z score.
Conclusion: Considering that similar studies have been conducted at a limited level, it is suggested that more comprehensive studies be conducted to more accurately investigate and determine the relationship between Vitamin D and osteoporosis in KTPs.
Methods: This descriptive-analytical cross-sectional study included 50 KTPs in Birjand, Iran, who had passed at least one year after a kidney transplant. Vitamin D serum level and bone mineral density (BMD) were measured by the Dual-Energy X-Ray Absorptiometry method. Data analysis was done using SPSS software (version 19) and statistical tests, such as Fisher's exact test, chi-square, independent samples t-test, and Pearson correlation coefficient at α=0.05 level.
Results: Vitamin D level showed no significant relationship with BMD, T score, and Z score. The mean of Z SPINE, Z RAD, T SPINE, T HIP, and T RAD in women was significantly higher than that of men (P<0.05). Moreover, no statistically significant linear correlation of vitamin D levels was observed with T-score and Z-score indices according to age in the studied patients. Finally, the results showed no significant relationship of Vitamin D levels with BMD, T score, and Z score.
Conclusion: Considering that similar studies have been conducted at a limited level, it is suggested that more comprehensive studies be conducted to more accurately investigate and determine the relationship between Vitamin D and osteoporosis in KTPs.
Type of Study: Research |
Subject:
Urology
Received: 2025/02/18 | Accepted: 2025/08/16 | ePublished ahead of print: 2025/09/6
Received: 2025/02/18 | Accepted: 2025/08/16 | ePublished ahead of print: 2025/09/6
References
1. Kovesdy CP. Epidemiology of chronic kidney disease: an update 2022. Kidney Int Suppl . 2022;12(1):7-11. [DOI:10.1016/j.kisu.2021.11.003]
2. Liyanage T, Toyama T, Hockham C, Ninomiya T, Perkovic V, Woodward M, et al. Prevalence of chronic kidney disease in Asia: a systematic review and analysis. BMJ Glob Health. 2022;7(1):e007525. [DOI:10.1136/bmjgh-2021-007525]
3. Bouya S, Balouchi A, Rafiemanesh H, Hesaraki MJTa, dialysis. Prevalence of chronic kidney disease in Iranian general population: a meta‐analysis and systematic review. Ther Apheresis Dial. 2018;22(6):594-9. [DOI:10.1111/1744-9987.12716]
4. Yan MT, Chao CT, Lin SH. Chronic Kidney Disease: Strategies to Retard Progression. Int J Mol Sci. 2021;22(18):10084. [DOI:10.3390/ijms221810084]
5. Vernooij RW, Law W, Peters SA, Canaud B, Davenport A, Grooteman MP, et al. The probability of receiving a kidney transplantation in end-stage kidney disease patients who are treated with haemodiafiltration or haemodialysis: a pooled individual participant data from four randomised controlled trials. BMC Nephrol. 2021;22(1):1-9. [DOI:10.1186/s12882-021-02265-6]
6. Overbeck I, Bartels M, Decker O, Harms J, Hauss J, Fangmann J. Changes in quality of life after renal transplantation. Transplant Proc. 2005;37(3):1618-21. [DOI:10.1016/j.transproceed.2004.09.019]
7. Lips P, Goldsmith D, de Jongh R. Vitamin D and osteoporosis in chronic kidney disease. J Nephrol. 2017;30(5):671-5. [DOI:10.1007/s40620-017-0430-x]
8. Kim SM, Long J, Montez-Rath M, Leonard M, Chertow GM. Hip Fracture in Patients With Non-Dialysis-Requiring Chronic Kidney Disease. J Bone Miner Res. 2016;31(10):1803-9. [DOI:10.1002/jbmr.2862]
9. Taweesedt PT, Disthabanchong S. Mineral and bone disorder after kidney transplantation. World J Transplant. 2015;5(4):231-42. [DOI:10.5500/wjt.v5.i4.231]
10. Kim CS, Kim SW. Vitamin D and chronic kidney disease. Korean J Intern Med. 2014;29(4):416-27. [DOI:10.3904/kjim.2014.29.4.416]
11. Wheeler DC, Winkelmayer WC. KDIGO 2017 clinical practice guideline update for the diagnosis, evaluation, prevention, and treatment of chronic kidney disease-mineral and bone disorder (CKD-MBD). Kidney Int Suppl. 2017;7(1):1-59. [DOI:10.1016/j.kisu.2017.04.001]
12. Battaglia Y, Bellasi A, Bortoluzzi A, Tondolo F, Esposito P, Provenzano M, et al. Bone Mineral Density Changes in Long-Term Kidney Transplant Recipients: A Real-Life Cohort Study of Native Vitamin D Supplementation. Nutrients. 2022;14(2):323. [DOI:10.3390/nu14020323]
13. Nuti R, Brandi ML, Checchia G, Di Munno O, Dominguez L, Falaschi P, et al. Guidelines for the management of osteoporosis and fragility fractures. Intern Emerg Med. 2019;14(1):85-102. [DOI:10.1007/s11739-018-1874-2]
14. Massry SG, Coburn JW, Chertow GM, Hruska K, Langman C, Malluche H, et al. K/DOQI clinical practice guidelines for bone metabolism and disease in chronic kidney disease. Am J Kidney Dis. 2003;42(4):1-201.
15. Restrepo Valencia CA, Aguirre Arango JV, Escobar DC. Determination of vitamin D (25[OH]D) levels in kidney transplant patients and relevance thereof, in accordance with the glomerular filtration rate. Rev Colomb Reumatol. 2018;25(3):161-8. [DOI:10.1016/j.rcreue.2019.01.005]
16. Battaglia Y, Bellasi A, Bortoluzzi A, Tondolo F, Esposito P, Provenzano M, et al. Bone Mineral Density Changes in Long-Term Kidney Transplant Recipients: A Real-Life Cohort Study of Native Vitamin D Supplementation. Nutrients. 2022;14(2):323. [DOI:10.3390/nu14020323]
17. Gheiasi B, Hadavi M, Asadzadeh R, Taghinezhad F, Mahmodzadeh R, Mozafari A. Bone Density Reduction and Its Associated Factors in Kidney Transplant Recipients: A Cross-Sectional Study. Int J Organ Transplant Med. 2022;13(1):5-11.
18. Holick MF. High prevalence of vitamin D inadequacy and implications for health. Mayo Clinproc. 2006;81(3):353-73. [DOI:10.4065/81.3.353]
19. Mahdavi M, Hamidi Z, Soltani A, Sedaghat M, Pezeshki ML, Larijani B. Bone Mineral Density in Iranian Kidney Graft Recipients and Its Relation to Biochemical and PTH Serum Levels. Iran J Public Health. 2004;33(1):70-5.
20. Sharifipour F, Bahrami A, Esmaeili H, Zeraati AA, Kalani Moghaddam F, Hami M, et al. Prevalence of low Mineral Bone Density in Renal Transplant Recipients one Year or More after Transplantation. medical journal of mashhad university of medical sciences. 2011;54(4):207-11.
21. Mojahedi MJ, Sharifipour F, Hami M, Saghafi M, Dadpour B, Saadati N. Assessment of Bone Density in Patients before and after Kidney Transplantation. Medical journal of mashhad university of medical sciences. 2009;52(4):215-9.
22. Davachi F, Ghods A. Assessment of Reduction in Bone Density after Renal Transplantation in 10 Patients in Hasheminejad Hospital. Razi J Med Sci. 2005;12(47):53-8.
23. Gregorini M, Sileno G, Pattonieri EF, Corradetti V, Abelli M, Ticozzelli E, et al. Understanding Bone Damage After Kidney Transplantation: A Retrospective Monocentric Cross Sectional Analysis. Transplant Proc. 2017;49(4):650-7. [DOI:10.1016/j.transproceed.2017.02.023]
24. Ball AM, Gillen DL, Sherrard D, Weiss NS, Emerson SS, Seliger SL, et al. Risk of hip fracture among dialysis and renal transplant recipients.JAMA. 2002;288(23):3014-8. [DOI:10.1001/jama.288.23.3014]
25. Khairallah P, Nickolas TL. Bone and Mineral Disease in Kidney Transplant Recipients. Clin J Am Soc Nephrol. 2022;17(1):121-30. [DOI:10.2215/CJN.03410321]
26. Marques IDB, Araújo M, Graciolli FG, Dos Reis LM, Pereira RMR, Alvarenga JC, et al. A Randomized Trial of Zoledronic Acid to Prevent Bone Loss in the First Year after Kidney Transplantation. J Am Soc Nephrol. 2019;30(2):355-65. [DOI:10.1681/ASN.2018060656]
27. Stavroulopoulos A, Cassidy MJ, Porter CJ, Hosking DJ, Roe SD. Vitamin D Status in Renal Transplant Recipients. Am J Transplant. 2007;7(11):2546-52. [DOI:10.1111/j.1600-6143.2007.01978.x]
28. Canalis E, Mazziotti G, Giustina A, Bilezikian JP. Glucocorticoid-induced osteoporosis: pathophysiology and therapy. Osteoporosis Int. 2007;18(10):1319-28. [DOI:10.1007/s00198-007-0394-0]
29. Evenepoel P, Naesens M, Claes K, Kuypers D, Vanrenterghem Y. Tertiary 'hyperphosphatoninism' accentuates hypophosphatemia and suppresses calcitriol levels in renal transplant recipients. Am J Transplant. 2007;7(5):1193-200. [DOI:10.1111/j.1600-6143.2007.01753.x]
30. McGregor R, Li G, Penny H, Lombardi G, Afzali B, Goldsmith DJ. Vitamin D in renal transplantation - from biological mechanisms to clinical benefits. Am J Transplant. 2014;14(6):1259-70. [DOI:10.1111/ajt.12738]
31. Dawson-Hughes B, Mithal A, Bonjour JP, Boonen S, Burckhardt P, Fuleihan GEH, et al. IOF position statement: vitamin D recommendations for older adults. Osteoporosis Int. 2010;21(7):1151-4. [DOI:10.1007/s00198-010-1285-3]
32. Obi Y, Hamano T, Ichimaru N, Tomida K, Matsui I, Fujii N, et al. Vitamin D Deficiency Predicts Decline in Kidney Allograft Function: A Prospective Cohort Study. J Clin Endocrinol Metab. 2014;99(2):527-35. [DOI:10.1210/jc.2013-2421]
33. Saber A, Fotuhi F, Rostami Z, Einollahi B, Nemati E. Vitamin D Levels After Kidney Transplantation and the Risk of Cytomegalovirus Infection. Nephrourol Mon. 2015;7(6):e29677. [DOI:10.5812/numonthly.29677]
34. Kwon YE, Kim H, Oh HJ, Park JT, Han SH, Ryu D-R, et al. Vitamin D Deficiency Is an Independent Risk Factor for Urinary Tract Infections After Renal Transplants. Medicine. 2015;94(9):e594. [DOI:10.1097/MD.0000000000000594]
35. Han B, Wu X, Guo Y. Improvement of fatigue after vitamin D supplementation in kidney transplant recipients. Medicine. 2017;96(21):e6918. [DOI:10.1097/MD.0000000000006918]
36. Neves CL, dos Reis LM, Batista DG, Custodio MR, Graciolli FG, Martin RD, et al. Persistence of Bone and Mineral Disorders 2 Years After Successful Kidney Transplantation. Transplantation. 2013;96(3):290-6. [DOI:10.1097/TP.0b013e3182985468]
37. Le Fur A, Fournier M-C, Gillaizeau F, Masson D, Giral M, Cariou B, et al. Vitamin D deficiency is an independent risk factor for PTDM after kidney transplantation. Transplant Int. 2016;29(2):207-15. [DOI:10.1111/tri.12697]
38. Ugalde-Altamirano J, Álvarez Villegas D, Revuelta I, Coloma A, Torregrosa JV. Relationship Between Vitamin D Blood Levels and Cancer Development in Renal Transplant Patients: A Case-Control Study. Transplant Proc. 2016;48(9):2959-61. [DOI:10.1016/j.transproceed.2016.09.010]
39. Reichrath J. Dermatologic management, sun avoidance and vitamin D status in organ transplant recipients (OTR). J Photochem Photobiol B. 2010;101(2):150-9. [DOI:10.1016/j.jphotobiol.2010.04.001]
40. Nazemian SS, Ghorban Sabbaq M, Nazemian F, Salehi M, Madani Sani F. Assessment of Circannual Rhythm in Plasma Level of Vitamin D Among Kidney Transplant Recipients in Mashhad. Iran J Kidney Dis. 2016;10(4):224-7.
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