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Previous issue date: 2017-12-04 / A hipovitaminose D tem sido demonstrada em doentes renais. Nos indiv?duos submetidos ao transplante renal, pode causar progress?o da albumin?ria, aumentando o decl?nio da fun??o renal e o risco de perda de enxerto. O objetivo do estudo ? avaliar o status da vitamina D em indiv?duos submetidos ao transplante renal e sua rela??o com os par?metros da fun??o renal no tempo zero, 3 meses e 6 meses p?s-transplante. Trata-se de um estudo longitudinal desenvolvido com 49 transplantados renais no per?odo de agosto de 2015 a janeiro de 2017. No tempo zero foram exclu?dos 3 indiv?duos devido a suplementa??o de vitamina D (n=46), nos 3 meses houve 1 ?bito, 1 desist?ncia e 2 rejei??es ajudas do enxerto (n=43) e aos 6 meses 1 paciente apresentou rejei??o aguda do enxerto (n=42). Os indiv?duos foram submetidos ? avalia??o antropom?trica, avalia??o da exposi??o solar, an?lises bioqu?micas, incluindo 25-hidroxivitamina D [25(OH)D], e coleta de urina para avaliar a rela??o albumina: creatinina (RAC) em todos os tempos estudados. A taxa de filtra??o glomerular (TFG) foi estimada pela equa??o da Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI). A idade mediana dos indiv?duos foi de 44 anos, a maioria do sexo masculino (60,9%; n=28) e a etnia parda (73,9%; n=34). Houve uma predomin?ncia de indiv?duos com hipovitaminose D nos tr?s tempos estudados. Os indiv?duos com status de vitamina D adequado nos 6 meses p?s-transplante apresentaram exposi??o solar significativamente maior em compara??o aos indiv?duos com hipovitaminose D (p = 0,008). Nos 6 meses p?s-transplante, 45,2% dos indiv?duos (n = 19) apresentaram hipovitaminose D em todos os momentos e 19,1% (n = 8) desenvolveram hipovitaminose D aos 3 meses, totalizando 27 indiv?duos com esse perfil. Desses, 37,0% (n = 10) n?o apresentaram melhora na TFG. A RAC de indiv?duos com hipovitaminose D foi maior aos 6 meses p?s-transplante em rela??o ao grupo com status adequado (p = 0,037) e correlacionada negativamente com o 25(OH)D (r = - 0,358; p = 0,02). O paratorm?nio (PTH) apresentou uma influ?ncia negativa na TFG no tempo zero e correlacionou-se positivamente com a RAC aos 6 meses ap?s o transplante (r = 0,420; p = 0,007). Em conclusao, existe uma alta frequ?ncia de hipovitaminose D nos indiv?duos at? 6 meses ap?s o transplante renal, sendo este status poss?velmente relacionado as altera??es observadas na fun??o renal do enxerto.S?o necess?rios mais estudos que apoiem interven??es, tais como suplementa??o de vitamina D, a fim de suportar os resultados obtidos para os pacientes neste est?gio p?s-transplante renal. / Hypovitaminosis D has been a frequent finding in renal patients. In kidney transplant recipients, this may cause progression of albuminuria, increasing the decline in renal function and the risk of graft loss. The objective of this study was to evaluate the vitamin D status in kidney transplant recipients and its relation with renal function parameters at time zero, 3 months and 6 months post-transplantation. This is a longitudinal study with 46 kidney transplant recipients from August 2015 to January 2017. At zero time, 3 subjects were excluded due to vitamin D supplementation (n = 46), in 3 months there was 1 death, 1 (n = 43) and at 6 months 1 patient presented acute rejection of the graft (n = 42). The subjects were evaluated using anthropometric evaluation, a sun exposure questionnaire, biochemical evaluation, including 25-hydroxyvitamin D [25(OH)D], and urine collection to evaluate the albumin: creatinine ratio (ACR) at all times studied. The glomerular filtration rate (GFR) was computed by the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation.
The median age of the subjects was 44 years, predominantly males (60.9%; n=28), and with brown ethnicity (73.9%; n=34). Most of the subjects had hypovitaminosis D during the three studied periods. In subjects with adequate Vitamin D status at 6 months post-transplant, the sun exposure was significantly lower. At 6 months post-transplant, 45.2% (n=19) presented with hypovitaminosis D at all times, and 19.1% (n=8) developed hypovitaminosis D at 3 months, totalizing 27 individuals with this profile. Of these, 37.0% (n=37) had no improvement in the GFR. The ACR of subjects with hypovitaminosis D were higher at six months post-transplant (p=0.037). This was negatively correlated with the 25(OH)D (r=- 0.358; p=0.02). The parathyroid hormone (PTH) had a negative influence on GFR at time zero but was positively correlated with ACR at six months post-transplantation (r=0.420; p=0.007). Therefore, there is a high frequency of hypovitaminosis D up to 6 months after renal transplantation, which may be related to greater changes in graft renal function. More studies are needed to support interventions, such as supplementation, in order to obtain better results after renal transplantation.
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.ufrn.br:123456789/24914 |
| Date | 04 December 2017 |
| Creators | Lima, Mabelle Alves Ferreira de |
| Contributors | 05410395808, Lima, Josivan Gomes de, 72116765404, Botelho, Patr?cia Borges, 07386866623, Evangelista, Karine Cavalcanti Mauricio de Sena, Rezende, Adriana Augusto de |
| Publisher | PROGRAMA DE P?S-GRADUA??O EM NUTRI??O, UFRN, Brasil |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Source | reponame:Repositório Institucional da UFRN, instname:Universidade Federal do Rio Grande do Norte, instacron:UFRN |
| Rights | info:eu-repo/semantics/openAccess |
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