Periods of vitamin D deficiency predispose kidney transplant patients to increased incidence of infection – retrospective single-centre study in Hungary

Transplant recipient patients are susceptible to infections due to their immunosuppressive treatments and surgical intervention. Vitamin D has positive effects on the immune system and metabolism promoting healthier homeostasis and more efficient immune response, thus is an advisable complementary therapy in kidney transplant recipients (KTRs). Poisson regressions were used to analyse associations between incidence of infections and vitamin D levels and deficiency. Group comparisons explored the connections between vitamin D levels and infections, calcium, and phosphate levels in relation to kidney function and parathyroid hormone (PTH) levels in deficiency/insufficiency/sufficiency periods of KTRs. KTRs had significantly lower level of 25(OH)D during infected compared to infection-free periods (p<0.0001). The incidence/number of infections was significantly higher during vitamin D deficiency compared to insufficiency or sufficiency (p<0.0001). Calcium level was significantly higher in the sufficient group compared to the insufficient or deficient groups (p=0.0031 and p=0.0496, respectively). Periods of vitamin D deficiency in KTRs are associated with vulnerability to infections, therefore monitoring of vitamin D level and applying supplementation reaching the sufficient level (30ng/ml) is recommended if deficiency is detected. Primarily to reduce infections and avoid disturbances in immune activation, but also because it has negative impact on the quality of life of KTRs.