Renal transplantation ve 1,25-(oh)2-vitamine D3

Although overall survival after kidney transplantation has strongly improved, stable renal transplant recipients remain at a strongly increased risk of metabolic complications. These complications are more related with bone and mineral metabolism diseases. Since vitamin D deficiency and insufficiency are common in chronic renal failure patients, the measurement of vitamin D with a reliable method is very important. Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS) is a gold standard method for the measurement of vitamin D. The purpose of this study was to demonstrate the relationship between vitamin D, calcium, phosphorus metabolism with graft function and to measure 1,25(OH)2D3 levels with LC-MS/MS in renal transplant recipients. This study included 30 renal transplant recipients (10 female, 20 male; mean age: 40.30±12.86) from living related donors which were transplanted in Akdeniz University, Faculty of Medicine. Blood samples were collected immediately before and after transplantation at month 6. Serum creatinine, BUN, calcium, phosphorus, alkaline phosphatase, glucose, albumin, PTH, 25(OH)D and 1,25(OH)2D3 levels were measured. GFR values were estimated by Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI). Plasma 1,25(OH)2D3 levels were determined in a LCMS-8040 triple quadrupole tandem mass spectrometer (Shimadzu Corporation, Japan) by multiple reaction monitoring (MRM). SPSS 20.0 software was used for statistical analysis. Although plasma 1,25(OH)2D3 levels significantly increased (p=0.0001), we did not find any significant differences for serum 25(OH)D levels after transplantation. When posttransplant levels of serum phosphorus, PTH, creatinin, BUN and ALP levels were found to be significantly decreased (p=0.0001, p=0.011 for ALP), we observed significantly higher calcium and GFR values (p=0.0001). Vitamin D insufficiency was present 13.3%, deficiency 36.7%, severe deficiency 50% before transplantation, insufficiency was also seen 26.7%, deficiency 50%, severe deficiency 23.3% after transplantation at month 6. There are limited studies that assess the incidence of vitamin D deficiency and insufficiency in our country after transplantation. In our study, vitamin D deficiency and insufficiency incidences were higher than the literature data. Determination of vitamin D deficiency and consequently treatment with vitamin D supplements could lead to better graft surveys and ultimately improve the outcome of renal transplantation. Key words: renal transplantation, 1,25(OH)2D3, vitamine D, LC-MS/MS