Vitamin D influences the prevalence of non-cutaneous carcinomas after kidney transplantation?

Abstract

ABSTRACTMalignancy is a key factor that significantly reduces the graft and patient survival after kidney transplantation. Vitamin D (VD) is gaining attention for its pleiotropy, including neoplasia prevention. The aim of our study was to assess the possible association between de novo non-cutaneous carcinomas (non-cuCa) and the VD status in kidney transplant recipients (KTRs). All patients followed up in our transplant center were included in the study from May 2012 until May 2016. We compared KTRs with non-cuCa to those without carcinomas. The demographic characteristics, immunosuppression protocols and 25-hydroxyvitamin D levels were evaluated. Patients with unstable kidney function, renal transplant duration less than 5 years, other malignancies, cholecalciferol supplementation and outliers for VD were not included in the study. KTRs with virus-associated carcinomas were also excluded. The total 25-hydroxyvitamin D was measured by a validated liquid chromatography–tandem mass spectrometry (LC-MS/MS) method. Two hundred fifty-six patients met the selection criteria. Of these, 11 were detected with non-cuCa with different organ localisation. The VD deficient patients had higher non-cuCa prevalence compared to the rest of the cohort (16.7% vs. 3.4%, p = 0.034). The VD status was significantly lower in the patients with malignancy (39.27 ± 18.16 vs. 59.87 ± 22.82 nmol, p = 0.005). No other significant differences between the two groups were detected. Poorer VD status may be an independent risk factor for post-transplant non-cutaneous cancer. VD supplementation may be considered as an option to reduce non-cuCa prevalence after kidney transplantation.