MANUSCRIPT TITLE: INFLUENCE OF ACTIVE VITAMIN D THERAPY ON PROTEINURIA AND GLOMERULAR FILTRATION RATE IN PATIENTS OPERATED ON KIDNEY TRANSPLANTATION.
*Dr. İrem Akın Şen, Dr. Özlem Tiryaki and Dr. Cem ŞEN
Background: Vitamin D deficiency is frequently seen in the studies performed on kidney transplantation patients. This study, aimed at comparing the influences of active vitamin D therapy on the proteinuria and glomerular filtration rate (GFR) in kidney transplant patients. Methods: The patients were divided into two groups: patients having parathormone (PTH) level >400 pg/ml, no diabetes and kidney transplantation and patients with PTH level < 400 pg/ml. The first group received 25 ?g of active vitamin D /day. Vitamin D, complete blood count, biochemical parameters and used immunosuppressive drug levels (steroid, tacrolimus) were recorded for all patients. The patients underwent the active vitamin D therapy for six months, once in every 15 days. Vitamin D was serologically studied through the HPLC (high-performance liquid chromatography) method. Results: The proteinuria level baseline values of the patients getting the active vitamin D therapy were 158.09±58.84 mg/day in the 0th month and 123.32±51.74 mg/day in the 6th month (p: 0.02). These values were 124±22 mg/day and 122±23.1 mg/day in the control group, respectively. The baseline values of GFR levels for the patients getting vitamin D therapy were 67.59?26.13 ml/min/1.73m2 in the 0th month, 76.45±14.23 ml/min/1.73m2 in the 6th month, and the p-value was 0.000 when it was considered in terms of the glomerular filtration rate. These values were 95?14 and 96?12.2 in the control group, respectively. While vitamin D baseline values were 8.6±6.2 ng/ml when it was evaluated in terms of vitamin D levels, vitamin D was found as 19.14±7.02 ng/ml in the 6th-month control (p: 0.0000). These values were 23.03±8.98 ng/ml and 21.02±6.78 ng/ml in the control group, respectively. While a negative correlation was determined between vitamin D level in the patients getting the active vitamin D therapy and proteinuria (p<0.001), a significant positive correlation was detected between the GFR levels (p<0.001). Conclusions: Vitamin D deficiency is highly seen in the patients who underwent kidney transplantation. There were no differences found between the patients who received and who did not receive the active vitamin D, in terms of age, body mass index (BMI), blood pressure, laboratory values (creatinine, lipid levels, haemoglobin, urea, uric acid) and donor features. Vitamin D plays a primary role in bone metabolism, Ca and P balance. Vitamin D provides regulatory influences in the renal, cardiac protection and immune system besides the metabolic functions in the kidney transplant patients, as a conclusion, Vitamin D level should be routinely checked in these patients in the light of these results.[Full Text Article]