{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:52:55Z","timestamp":1787028775360,"version":"build-2736575974"},"reference-count":42,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2022,10,20]],"date-time":"2022-10-20T00:00:00Z","timestamp":1666224000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>The aim of this systematic review is to assess the impact of vitamin D on the outcomes of kidney transplantation and investigate whether its deficiency is associated with a negative impact. Methods: We conducted a systematic literature search in PubMed, Scopus and Cochrane databases, as well as gray literature. Ultimately, 16 articles with an average of 255.75 patients were included in this review. These articles compared the long-term outcomes of vitamin D deficiency and\/or vitamin D supplementation therapy on kidney transplant recipients by assessing various parameters. Results: Most of the included studies showed a negative effect of vitamin D deficiency on kidney transplantation by being associated with a worse graft function, higher incidence of acute rejection episodes, higher incidence of proteinuria and lower overall graft and patient survival rate. Conclusions: We suggest that patients awaiting kidney transplantation have a careful evaluation in order to assess their vitamin D status and the optimal supplementation therapy. Regular follow-up of vitamin D levels post-transplant is also suggested. Prospective studies will be needed to establish the positive effects of vitamin D supplementation therapy on kidney transplant outcomes.<\/jats:p>","DOI":"10.3390\/life12101664","type":"journal-article","created":{"date-parts":[[2022,10,20]],"date-time":"2022-10-20T22:49:46Z","timestamp":1666306186000},"page":"1664","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["The Role of Vitamin D in Kidney Transplantation Outcomes: A Systematic Review"],"prefix":"10.3390","volume":"12","author":[{"given":"Georgios","family":"Koimtzis","sequence":"first","affiliation":[{"name":"Cardiff Transplant Unit, University Hospital of Wales, Cardiff and Vale University Health Board, Cardiff CF14 4XW, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2682-5639","authenticated-orcid":false,"given":"Leandros","family":"Stefanopoulos","sequence":"additional","affiliation":[{"name":"Lab of Computing, Medical Informatics and Biomedical Imaging Technologies, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Verity","family":"Brooker","sequence":"additional","affiliation":[{"name":"Cardiff Transplant Unit, University Hospital of Wales, Cardiff and Vale University Health Board, Cardiff CF14 4XW, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios","family":"Geropoulos","sequence":"additional","affiliation":[{"name":"Department of Academic Surgery, The Royal Marsden Hospital Foundation Trust, 203 Fulham Rd., London SW3 6JJ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6206-8420","authenticated-orcid":false,"given":"Christopher G.","family":"Chalklin","sequence":"additional","affiliation":[{"name":"Cardiff Transplant Unit, University Hospital of Wales, Cardiff and Vale University Health Board, Cardiff CF14 4XW, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8436-2858","authenticated-orcid":false,"given":"Sapna","family":"Gupta","sequence":"additional","affiliation":[{"name":"Cardiff Transplant Unit, University Hospital of Wales, Cardiff and Vale University Health Board, Cardiff CF14 4XW, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eliot","family":"Carrington-Windo","sequence":"additional","affiliation":[{"name":"Cardiff Transplant Unit, University Hospital of Wales, Cardiff and Vale University Health Board, Cardiff CF14 4XW, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3149-6523","authenticated-orcid":false,"given":"Maria","family":"Papaioannou","sequence":"additional","affiliation":[{"name":"Laboratory of Biological Chemistry, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodosios S.","family":"Papavramidis","sequence":"additional","affiliation":[{"name":"1st Propaedeutic Surgical Department, University Hospital of Thessaloniki AHEPA, Aristotle University of Thessaloniki (AUTH), 1st St. Kiriakidi Street, 54621 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,10,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"138","DOI":"10.3949\/ccjm.85gr.18001","article-title":"Kidney transplant: New opportunities and challenges","volume":"85","author":"Augustine","year":"2018","journal-title":"Clevel. Clin. J. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1016\/j.transproceed.2019.11.003","article-title":"Long-term kidney transplant outcomes: Role of prolonged-release tacrolimus","volume":"Volume 52","author":"Banas","year":"2020","journal-title":"Transplantation Proceedings"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"75","DOI":"10.6002\/ect.MESOT2018.O12","article-title":"Over 5 years of excellent graft kidney function determinants: Baskent University experience","volume":"17","author":"Sayin","year":"2019","journal-title":"Exp. Clin. Transpl."},{"key":"ref_4","first-page":"68","article-title":"Aging kidney transplantation","volume":"68","author":"Musso","year":"2016","journal-title":"Rev. Investig. Cl\u00edn."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"881","DOI":"10.2310\/JIM.0b013e31821b8755","article-title":"Vitamin D and the immune system","volume":"59","author":"Aranow","year":"2011","journal-title":"J. Investig. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1016\/j.coph.2010.04.001","article-title":"Vitamin D: Modulator of the immune system","volume":"10","author":"Baeke","year":"2010","journal-title":"Curr. Opin. Pharmacol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2502","DOI":"10.3390\/nu5072502","article-title":"Vitamin D and immune function","volume":"5","author":"Prietl","year":"2013","journal-title":"Nutrients"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Charoenngam, N., and Holick, M.F. (2020). Immunologic effects of vitamin D on human health and disease. Nutrients, 12.","DOI":"10.3390\/nu12072097"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"953","DOI":"10.2174\/1389557515666150519110830","article-title":"Vitamin-D in the immune system: Genomic and non-genomic actions","volume":"15","author":"Kloukina","year":"2015","journal-title":"Mini Rev. Med. Chem."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/2046-4053-3-64","article-title":"Vitamin D and kidney transplant outcomes: A protocol for a systematic review and meta-analysis","volume":"3","author":"Hesketh","year":"2014","journal-title":"Syst. Rev."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"630951","DOI":"10.3389\/fnut.2020.630951","article-title":"Vitamin D and Acute Kidney Injury: A Two-Way Causality Relation and a Predictive, Prognostic, and Therapeutic Role of Vitamin D","volume":"7","author":"Graidis","year":"2021","journal-title":"Front. Nutr."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"966","DOI":"10.1681\/ASN.2009080872","article-title":"Vitamin D receptor attenuates renal fibrosis by suppressing the renin-angiotensin system","volume":"21","author":"Zhang","year":"2010","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1696","DOI":"10.1046\/j.1523-1755.1998.00951.x","article-title":"Effect of 1,25(OH)2 vitamin D3 on glomerulosclerosis in subtotally nephrectomized rats","volume":"53","author":"Schwarz","year":"1998","journal-title":"Kidney Int."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1543","DOI":"10.1016\/S0140-6736(10)61032-X","article-title":"Selective vitamin D receptor activation with paricalcitol for reduction of albuminuria in patients with type 2 diabetes (VITAL study): A randomised controlled trial","volume":"376","author":"Agarwal","year":"2010","journal-title":"Lancet"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1053\/j.ajkd.2011.09.014","article-title":"Oral calcitriol for reduction of proteinuria in patients with IgA nephropathy: A randomized controlled trial","volume":"59","author":"Liu","year":"2012","journal-title":"Am. J. Kidney Dis."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"242","DOI":"10.4103\/ijn.IJN_307_18","article-title":"Vitamin D, 1, 25-Dihydroxyvitamin D, FGF23, and graft function after renal transplantation","volume":"29","author":"Mehrotra","year":"2019","journal-title":"Indian J. Nephrol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2054358117699822","DOI":"10.1177\/2054358117699822","article-title":"The risk of acute rejection following kidney transplant by 25-hydroxyvitamin D and 1, 25-dihydroxyvitamin D status: A prospective cohort study","volume":"4","author":"Zimmerman","year":"2017","journal-title":"Can. J. Kidney Health Dis."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1279","DOI":"10.1017\/S000711451700112X","article-title":"Vitamin D status in renal transplant recipients living in a low-latitude city: Association with body fat, cardiovascular risk factors, estimated glomerular filtration rate and proteinuria","volume":"117","author":"Rosina","year":"2017","journal-title":"Br. J. Nutr."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"224","DOI":"10.15171\/jrip.2018.52","article-title":"Low 25 (OH) Vitamin-D levels are associated with inferior graft function in living related kidney transplant recipients","volume":"7","author":"Mehrotra","year":"2018","journal-title":"J. Ren. Inj. Prev."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1210\/jc.2013-2421","article-title":"Vitamin D deficiency predicts decline in kidney allograft function: A prospective cohort study","volume":"99","author":"Obi","year":"2014","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1210\/jc.2014-3012","article-title":"Associations of 25(OH) and 1,25(OH)2 vitamin D with long-term outcomes in stable renal transplant recipients","volume":"100","author":"Keyzer","year":"2015","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1097\/TP.0000000000000055","article-title":"Circulating levels of 25-hydroxyvitamin D and acute cellular rejection in kidney allograft recipients","volume":"98","author":"Lee","year":"2014","journal-title":"Transplantation"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1681\/ASN.2012060614","article-title":"Vitamin D status and outcomes after renal transplantation","volume":"24","author":"Girard","year":"2013","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"3002","DOI":"10.1016\/j.transproceed.2009.07.087","article-title":"1,25-dihydroxyvitamin D deficiency predicts poorer outcome after renal transplantation","volume":"Volume 41","author":"Falkiewicz","year":"2009","journal-title":"Transplantation Proceedings"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1016\/j.transproceed.2011.01.083","article-title":"Influence of 1,25-dihydroxyvitamin D3 on human leukocyte antigen-DR expression, macrophage infiltration, and graft survival in renal allografts","volume":"Volume 43","author":"Sezer","year":"2011","journal-title":"Transplantation Proceedings"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2823","DOI":"10.1016\/j.transproceed.2009.06.141","article-title":"Vitamin D status, bone mineral density, and inflammation in kidney transplantation patients","volume":"Volume 41","author":"Sezer","year":"2009","journal-title":"Transplantation Proceedings"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"3723","DOI":"10.1016\/j.transproceed.2011.08.081","article-title":"Impact of vitamin D on proteinuria, insulin resistance, and cardiovascular parameters in kidney transplant recipients","volume":"Volume 43","author":"Lee","year":"2011","journal-title":"Transplantation Proceedings"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e13517","DOI":"10.1111\/ctr.13517","article-title":"Vitamin D as a risk factor for patient survival after kidney transplantation: A prospective observational cohort study","volume":"33","author":"Thorsen","year":"2019","journal-title":"Clin. Transplant."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1159\/000065289","article-title":"A retrospective evaluation of 1, 25-dihydroxyvitamin D3 and its potential effects on renal allograft function","volume":"22","author":"Hullett","year":"2002","journal-title":"Am. J. Nephrol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1347","DOI":"10.1111\/ctr.12829","article-title":"1, 25 Dihydroxyvitamin D circulating levels, calcitriol administration, and incidence of acute rejection, CMV infection, and polyoma virus infection in renal transplant recipients","volume":"30","author":"Moscarelli","year":"2016","journal-title":"Clin. Transplant."},{"key":"ref_31","first-page":"629","article-title":"Higher 25-hydroxyvitamin D levels are associated with lower proteinuria in kidney transplant recipients","volume":"14","author":"Filipov","year":"2016","journal-title":"Exp Clin Transpl."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"950","DOI":"10.1093\/nutrit\/nuab058","article-title":"Prevalence of vitamin D deficiency and impact on clinical outcomes after kidney transplantation: A systematic review and meta-analysis","volume":"80","author":"Yin","year":"2022","journal-title":"Nutr. Rev."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"101410","DOI":"10.1016\/j.trim.2021.101410","article-title":"The association between vitamin D and acute rejection in human kidney transplantation: A systematic review and meta-analysis study","volume":"67","author":"Mirzakhani","year":"2021","journal-title":"Transpl. Immunol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1159\/000491041","article-title":"Secondary and tertiary hyperparathyroidism","volume":"51","author":"Messa","year":"2019","journal-title":"Parathyr. Disord."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1062","DOI":"10.1007\/s12098-012-0765-1","article-title":"Vitamin D in chronic kidney disease","volume":"79","author":"Chau","year":"2012","journal-title":"Indian J. Pediatr."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Messa, P., Regalia, A., and Alfieri, C.M. (2017). Nutritional vitamin D in renal transplant patients: Speculations and reality. Nutrients, 9.","DOI":"10.3390\/nu9060550"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"2546","DOI":"10.1111\/j.1600-6143.2007.01978.x","article-title":"Vitamin D status in renal transplant recipients","volume":"7","author":"Stavroulopoulos","year":"2007","journal-title":"Am. J. Transplant."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1016\/B978-0-12-386960-9.00019-8","article-title":"Vitamin D in solid organ transplantation with special emphasis on kidney transplantation","volume":"86","author":"Thiem","year":"2011","journal-title":"Vitamins Hormones"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1080\/13102818.2014.995415","article-title":"Relationship between vitamin D status and immunosuppressive therapy in kidney transplant recipients","volume":"29","author":"Filipov","year":"2015","journal-title":"Biotechnol. Biotechnol. Equip."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1093\/ndt\/gfy399","article-title":"Joint association of vitamins D and K status with long-term outcomes in stable kidney transplant recipients","volume":"35","author":"Beulens","year":"2020","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1375","DOI":"10.1586\/1744666X.2014.949674","article-title":"Vitamin D: A new player in kidney transplantation?","volume":"10","author":"Ponticelli","year":"2014","journal-title":"Expert Rev. Clin. Immunol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"866","DOI":"10.1053\/j.ajkd.2019.01.031","article-title":"Management of Kidney Transplant Recipients by General Nephrologists: Core Curriculum 2019","volume":"73","author":"Voora","year":"2019","journal-title":"Am. J. Kidney Dis."}],"container-title":["Life"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-1729\/12\/10\/1664\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:58:32Z","timestamp":1760144312000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-1729\/12\/10\/1664"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,20]]},"references-count":42,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2022,10]]}},"alternative-id":["life12101664"],"URL":"https:\/\/doi.org\/10.3390\/life12101664","relation":{},"ISSN":["2075-1729"],"issn-type":[{"value":"2075-1729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,20]]}}}