A Comparative Study of Renal Function and Vitamin D Levels Between African and Indian Transplant Recipients

Abstract

Introduction: There is a paucity of information on graft function in native African patients compared to Indian patients. As the Africans have higher BMI and muscle mass, they may have higher BUN and serum creatinine pre-transplantation. This study was undertaken to compare the outcome of transplantation with regard to renal function between the two groups. Materials and methods: Our retrospective study comprises 388 patients of Indian and African origin. Details such as age, gender, diabetic status, renal parameters pre and post-transplant, HLA typing, induction therapy, immunosuppressive medication and rejection rates were collected. Analysis was done using PASW Statistics 18 with chi-square test and one way Anova with post-hoc Tukey. All African patients received grafts from their own close relatives or spouses. Results: Of the 388 patients, 291 were Indian and 97 were of African origin. Details of the analysis are shown in Tables 1 and 2. It can be observed that the pre-transplant and immediate post-transplant renal function shown by blood urea and serum creatinine of the African patients were higher compared to their Indian counterparts (p< .001) However, the 1 month and 1 year post transplant renal functions were insignificantly different reflecting a similar overall outcome. While 38% of patients were diabetic, diabetic status was not significantly different. (p=0.153) A significant number of Indian patients had 1 or less HLA mismatches (44.5%) as compared to the African patients (15.9%) (p< .001). 27 patients died overall (6.9%) and mortality was not significantly different between the two ethnic groups. (p=0.106) Africans have higher levels of 25,OH Vitamin D3 levels (p=0.038)Table: [Demographic and Laboratory Parameters]Table: [Renal parameters]Conclusion: Our study shows that while the African population tended to have higher blood urea and creatinine pre and immediate post-operatively, this becomes insignificant at 1 month and 12 months and, thus, their overall outcome was similar to that of the Indian population despite a higher incidence of HLA mismatch. This may be attributed to achievement of adequate immunosuppression and overall higher Vitamin D levels.