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Endothelial dysfunction in renal transplant recipients: role of vitamin D and fibroblast growth factor-23.
Transplant Proc. 2015 Mar; 47(2):343-7.TP

Abstract

BACKGROUND

Endothelial dysfunction can be detected at early stages of chronic kidney disease. Although endothelial functions improve after successful renal transplantation, renal transplant recipients have still worse endothelial functions compared to healthy subjects. Vitamin D deficiency and high fibroblast growth factor-23 (FGF-23) levels may have a role on endothelial dysfunction in chronic kidney disease patients. The aim of this study is to investigate the association between endothelial functions, vitamin D, and FGF-23 levels in renal transplant recipients.

METHODS

One hundred nine renal transplant recipients (71 male, 38 female) underwent brachial flow-mediated dilatation (FMD), serum 25-OH vitamin D, and FGF-23 level measurements. Vitamin D and FGF-23 levels were compared between patients with normal and abnormal endothelial functions. Correlations between FMD, vitamin D, and FGF-23 were also investigated.

RESULTS

Endothelial functions were abnormal in 72.5% of the patients. Prevalence of vitamin D deficiency was 80.7%. Vitamin D levels were significantly lower in patients with endothelial dysfunction compared to patients with normal endothelial functions (12.6 ± 6.6 μg/L vs 17.3 ± 10.0 μg/L respectively, P = .02). FGF-23 levels were not different between the two groups. 25-OH vitamin D levels had a significant positive correlation with amount of FMD (r = 0.218 and P = .02) and were an independent predictor of FMD after adjusting for potential confounding factors including age, transplantation duration, body mass index, mean blood pressure, glomerular filtration rate, proteinuria, hemoglobin, and FGF-23 in multivariate regression analysis (beta = 0.194, P = .04). FGF-23 levels were not predictive of FMD in this model (beta: -0.125, P = .197) CONCLUSION: Vitamin D deficiency is associated with endothelial dysfunction in renal transplant recipients. Further clinical and experimental studies are necessary to define a causal relationship between the parameters, discover the potential mechanisms, and observe the effect of vitamin D replacement on endothelial functions in renal transplant recipients.

Authors+Show Affiliations

Hacettepe University Medical Faculty Nephrology Department, Ankara, Turkey. Electronic address: tolga.yildirim@hacettepe.edu.tr.Hacettepe University Medical Faculty Nephrology Department, Ankara, Turkey.Hacettepe University Medical Faculty Nephrology Department, Ankara, Turkey.Hacettepe University Medical Faculty Nephrology Department, Ankara, Turkey.Hacettepe University Medical Faculty Nephrology Department, Ankara, Turkey.Hacettepe University Medical Faculty Nephrology Department, Ankara, Turkey.Hacettepe University Medical Faculty Nephrology Department, Ankara, Turkey.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25769570

Citation

Yildirim, T, et al. "Endothelial Dysfunction in Renal Transplant Recipients: Role of Vitamin D and Fibroblast Growth Factor-23." Transplantation Proceedings, vol. 47, no. 2, 2015, pp. 343-7.
Yildirim T, Yilmaz R, Altindal M, et al. Endothelial dysfunction in renal transplant recipients: role of vitamin D and fibroblast growth factor-23. Transplant Proc. 2015;47(2):343-7.
Yildirim, T., Yilmaz, R., Altindal, M., Turkmen, E., Arici, M., Altun, B., & Erdem, Y. (2015). Endothelial dysfunction in renal transplant recipients: role of vitamin D and fibroblast growth factor-23. Transplantation Proceedings, 47(2), 343-7. https://doi.org/10.1016/j.transproceed.2014.12.023
Yildirim T, et al. Endothelial Dysfunction in Renal Transplant Recipients: Role of Vitamin D and Fibroblast Growth Factor-23. Transplant Proc. 2015;47(2):343-7. PubMed PMID: 25769570.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Endothelial dysfunction in renal transplant recipients: role of vitamin D and fibroblast growth factor-23. AU - Yildirim,T, AU - Yilmaz,R, AU - Altindal,M, AU - Turkmen,E, AU - Arici,M, AU - Altun,B, AU - Erdem,Y, PY - 2014/05/09/received PY - 2014/12/01/revised PY - 2014/12/31/accepted PY - 2015/3/15/entrez PY - 2015/3/15/pubmed PY - 2015/10/1/medline SP - 343 EP - 7 JF - Transplantation proceedings JO - Transplant Proc VL - 47 IS - 2 N2 - BACKGROUND: Endothelial dysfunction can be detected at early stages of chronic kidney disease. Although endothelial functions improve after successful renal transplantation, renal transplant recipients have still worse endothelial functions compared to healthy subjects. Vitamin D deficiency and high fibroblast growth factor-23 (FGF-23) levels may have a role on endothelial dysfunction in chronic kidney disease patients. The aim of this study is to investigate the association between endothelial functions, vitamin D, and FGF-23 levels in renal transplant recipients. METHODS: One hundred nine renal transplant recipients (71 male, 38 female) underwent brachial flow-mediated dilatation (FMD), serum 25-OH vitamin D, and FGF-23 level measurements. Vitamin D and FGF-23 levels were compared between patients with normal and abnormal endothelial functions. Correlations between FMD, vitamin D, and FGF-23 were also investigated. RESULTS: Endothelial functions were abnormal in 72.5% of the patients. Prevalence of vitamin D deficiency was 80.7%. Vitamin D levels were significantly lower in patients with endothelial dysfunction compared to patients with normal endothelial functions (12.6 ± 6.6 μg/L vs 17.3 ± 10.0 μg/L respectively, P = .02). FGF-23 levels were not different between the two groups. 25-OH vitamin D levels had a significant positive correlation with amount of FMD (r = 0.218 and P = .02) and were an independent predictor of FMD after adjusting for potential confounding factors including age, transplantation duration, body mass index, mean blood pressure, glomerular filtration rate, proteinuria, hemoglobin, and FGF-23 in multivariate regression analysis (beta = 0.194, P = .04). FGF-23 levels were not predictive of FMD in this model (beta: -0.125, P = .197) CONCLUSION: Vitamin D deficiency is associated with endothelial dysfunction in renal transplant recipients. Further clinical and experimental studies are necessary to define a causal relationship between the parameters, discover the potential mechanisms, and observe the effect of vitamin D replacement on endothelial functions in renal transplant recipients. SN - 1873-2623 UR - https://www.unboundmedicine.com/medline/citation/25769570/Endothelial_dysfunction_in_renal_transplant_recipients:_role_of_vitamin_D_and_fibroblast_growth_factor_23_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0041-1345(15)00011-1 DB - PRIME DP - Unbound Medicine ER -