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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Nephrol. Jun 25, 2026; 15(2): 117674
Published online Jun 25, 2026. doi: 10.5527/wjn.v15.i2.117674
Letter to the Editor: Post-transplant diabetes mellitus prevention in renal transplantation - are we missing vitamin D?
Adarsh Kumar, Himansu Sekhar Mahapatra
Adarsh Kumar, Department of Nephrology and Renal Transplant Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi 110029, India
Himansu Sekhar Mahapatra, Department of Nephrology, Atal Bihari Vajpayee Institute of Medical Science and Dr Ram Manohar Lohia Hospital, New Delhi 110001, India
Author contributions: Kumar A conceptualized the letter and drafted the manuscript; Mahapatra HS critically revised the letter; both authors approved the final manuscript.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
Corresponding author: Adarsh Kumar, DM, MD, Associate Professor, Department of Nephrology and Renal Transplant Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, Ansari Nagar East, Near AIIMS Metro Station, New Delhi 110029, India. adarshnephro081@gmail.com
Received: December 15, 2025
Revised: January 22, 2026
Accepted: February 13, 2026
Published online: June 25, 2026
Processing time: 184 Days and 10.1 Hours
Core Tip

Core Tip: Vitamin D deficiency is nearly universal among kidney transplant recipients (RTRs) but remains underappreciated as a contributor to post-transplant diabetes mellitus (PTDM). Recent evidence shows that low pre- and early post-transplant vitamin D levels independently increase PTDM risk. Integrating vitamin D optimization into transplant care may offer a simple strategy to prevent PTDM and improve long-term graft outcomes. Doses of vitamin D necessary to achieve a serum 25-hydroxyvitamin D concentration of ≥ 30 ng/mL in RTRs are much higher than those recommended in the general population. Vitamin D repletion is a safe, inexpensive, and widely accessible intervention that may enhance insulin secretion, improve insulin sensitivity, and attenuate the metabolic toxicity associated with calcineurin inhibitors and glucocorticoids. Further well-designed prospective studies are needed to elucidate underlying mechanisms and evaluate the impact of vitamin D supplementation on PTDM.

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