Relationship between vitamin D and post-transplant diabetes mellitus in kidney transplant recipients

doi:10.5527/wjn.v14.i4.113300

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Dec 25, 2025 (publication date) through Dec 23, 2025

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World Journal of Nephrology

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2220-6124

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Nephrol. Dec 25, 2025; 14(4): 113300
Published online Dec 25, 2025. doi: 10.5527/wjn.v14.i4.113300

Table 1 Baseline characteristics of the patients

	Total	PTDM	Controls	P value
Total patients	72	32	40
Male gender	61 (84.7)	30 (93.7)	31 (77.5)	0.057
Age (years), mean ± SD	32.4 ± 9.2	34.6 ± 9.6	30.7 ± 8.5	0.076
> 40	55 (76.3)	34 (85.0)	21 (65.0)	0.092
< 40	17 (23.6)	6 (15.0)	11 (35.0)	0.092
Dialysis vintage, months, median (minimum-maximum)	17.0 (12.0-25.5)	14.5 (10.0-24.5)	17.0 (13.0-27.0)	0.189
BMI, kg/m², mean ± SD	19.9 ± 3.8	20.5 ± 3.7	19.4 ± 3.9	0.266
BMI grading				0.338
0	28 (38.8)	9 (28.1)	19 (47.5)
1	26 (36.1)	19 (59.3)	17 (42.5)
2	5 (6.9)	3 (9.3)	2 (5.0)
3	3 (4.1)	1 (3.1)	2 (5.0)
BMI grading at 12 months
0	20 (27.7)	7 (21.8)	13 (32.5)	0.294
1	44 (61.1)	21 (65.6)	23 (57.5)
2	6 (8.3)	4 (12.5)	2 (5.0)
3	2 (2.7)	0	2 (5.0)
Recipient blood cohort
O	16 (22.2)	7 (21.8)	9 (22.5)	0.371
AB	5 (6.9)	1 (3.1)	4 (10.0)
A	20 (27.0)	7 (21.8)	13 (32.5)
B	30 (41.6)	17 (53.1)	13 (32.5)
Native kidney disease
Unclassified	43 (59.7)	16 (50.0)	27 (67.5)	0.714
Chronic TID	13 (18.0)	7 (21.8)	6 (15.0)
IgA	9 (12.5)	5 (15.6)	4 (10.0)
FSGS	4 (5.5)	2 (6.2)	2 (5.0)
MPGN	1 (1.3)	1 (3.1)	0
ADPKD	2 (2.7)	1 (3.1)	1 (2.5)
Family history of DM	6 (8.3)	5 (15.6)	1 (2.5)	0.045
History of smoking	2 (2.7)	2 (6.2)	0	0.113

Data are presented as n (%). PTDM: Post-transplant diabetes mellitus; BMI: Body mass index; TID: Tubulointerstitial disease; IgA: Immunoglobulin A nephropathy; FSGS: Focal segmental glomerulosclerosis; MPGN: Membranoproliferative glomerulonephritis; ADPKD: Autosomal dominant polycystic kidney disease; DM: Diabetes mellitus; SD: Standard deviation.

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Table 2 Donor and immunology details

	Total	PTDM	Control	P value
Total patients	72	32	40
Type of donor
Live donor	66 (91.6)	29 (90.6)	37 (92.5)	0.858
Deceased donor	6 (8.3)	3 (9.3)	3 (7.5)	0.858
Distribution of live donor
Parent	42 (58.3)	17 (53.1)	25 (62.5)	0.865
Spouse	18 (25.0)	9 (28.1)	9 (22.5)
Sibling	3 (4.1)	2 (6.2)	1 (2.5)
Unrelated	3 (4.1)	1 (3.1)	2 (2.5)
Number of HLA mismatch
1	3 (4.1)	2 (6.2)	1 (2.5)	0.304
2	11 (15.2)	5 (15.6)	6 (15.0)
3	33 (45.8)	11 (34.3)	22 (40.0)
4	6 (8.3)	3 (9.3)	3 (7.5)
5	7 (9.7)	3 (9.3)	4 (10.0)
6	6 (8.3)	5 (15.6)	1 (2.5)
High PRA	4 (5.5)	2 (5.0)	2 (5.0)	0.815
Induction agent
No induction	35 (48.6)	13 (40.6)	22 (55.0)	0.297
Basiliximab	26 (36.0)	12 (37.5)	14 (35.0)
ATG	11 (15.2)	7 (21.8)	4 (10.0)

Data are presented as n (%). PTDM: Post-transplant diabetes mellitus; HLA: Human leukocyte antigen; PRA: Panel reactive antibody; ATG: Antithymocyte globulin.

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Table 3 Patient outcomes and lab parameters during follow-up

	Total	PTDM	Controls	P value
Number of cases	72	32	40
Duration of follow-up (weeks)	46.9 ± 4.8	47.9 ± 0.2	46.1 ± 6.3	0.116
Acute rejection	12 (16.6)	3 (9.3)	9 (22.5)	0.138
MP pulse given	10 (13.8)	2 (6.2)	8 (20.0)	0.094
CMV infection	6 (8.3)	4 (12.5)	2 (5.0)	0.253
HCV infection	13 (18.0)	6 (18.7)	7 (21.0)	0.891
Serum vitamin D levels
> 30 ng/mL (sufficient)	10 (13.8)	2 (6.2)	8 (20.0)	0.007
20-30 ng/mL (insufficient)	18 (25.0)	4 (12.5)	14 (43.7)
< 20 ng/mL (deficient)	44 (61.0)	26 (81.2)	18 (56.2)
Serum calcium levels (mg/dL)	8.8 ± 0.08	9.0 ± 0.70	8.7 ± 0.60	0.080
Serum phosphate levels (mg/dL)	2.9 ± 0.7	3.1 ± 0.9	2.8 ± 0.5	0.231
Proteinuria(g/dL), median (minimum-maximum)	0.3 (0.2-0.4)	0.5 (0.3-0.7)	0.2 (0.2-0.3)	0.023
Serum creatinine (mg/dL), median (minimum-maximum)	1.2 (0.6-7.0)	1.3 (1.0-1.5)	1.1 (1.0-1.7)	0.367

Data are presented as n (%) or mean ± SD. PTDM: Post-transplant diabetes mellitus; MP: Methylprednisolone; CMV: Cytomegalovirus; HCV: Hepatitis C virus.

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Table 4 Multivariable logistic regression for post-transplant diabetes mellitus

Variable	Univariable OR (95%CI)	P value	Multivariable OR (95%CI)	P value
Female	0.22 (0.04-1.10)	0.067	0.28 (0.04-1.92)	0.194
Family history of diabetes mellitus	6.96 (0.77-62.93)	0.084	12.60 (0.86-185.40)	0.065
Vitamin D levels < 30 ng/mL	3.74 (0.73-19.09)	0.065	4.65 (0.75- 28.80)
Vitamin D levels < 20 ng/mL	5.30 (1.79-15.67)	0.003	8.21 (2.19-30.75)	0.002
Dialysis vintage	0.99 (0.97-1.02)	0.568	NA
Age > 40 years	3.24 (1.06-9.93)	0.040	3.96 (0.92-16.93)	0.064
Serum Ca²⁺	1.80 (0.92-3.51)	0.087	3.07 (1.22-7.72)	0.017
Induction therapy
Basiliximab	1.57 (0.57-4.36)	0.385	NA
ATG	2.96 (0.73-12.09)	0.130	NA

OR: Odds ratio; CI: Confidence interval; ATG: Antithymocyte globulin; NA: Not available.

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Citation: Singh D, Sangha SS, Yadav RK, Subbiah AK, Yadav S, Kumar A, Khadgawat R, Chaturvedi PK, Agarwal SK, Mahajan S, Pahuja T, Bhowmik D. Relationship between vitamin D and post-transplant diabetes mellitus in kidney transplant recipients. World J Nephrol 2025; 14(4): 113300
URL: https://www.wjgnet.com/2220-6124/full/v14/i4/113300.htm
DOI: https://dx.doi.org/10.5527/wjn.v14.i4.113300