Vitamin C deficiency after kidney transplantation: a cohort and cross-sectional study of the TransplantLines biobank

Purpose Vitamin C deficiency is associated with excess mortality in kidney transplant recipients (KTR). We aim to evaluate plasma vitamin C status at different post-transplantation moments and assess the main characteristics associated with vitamin C deficiency in KTR. Methods Plasma vitamin C was a...

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Published in:European journal of nutrition 2024-09, Vol.63 (6), p.2357-2366
Main Authors: Yepes-Calderón, Manuela, van der Veen, Yvonne, Martín del Campo S, Fernando, Kremer, Daan, Sotomayor, Camilo G., Knobbe, Tim J., Vos, Michel J., Corpeleijn, Eva, de Borst, Martin H., Bakker, Stephan J. L.
Format: Article
Language:English
Subjects:
Ascorbic acid
Chemistry
Chemistry and Materials Science
Diabetes
Diabetes mellitus
Dietary intake
Dietary supplements
Donors
Kidney transplantation
Nutrient deficiency
Nutrition
Original Contribution
Plasma
Risk factors
Transplants & implants
Vitamin C
Vitamin deficiency
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Summary:Purpose Vitamin C deficiency is associated with excess mortality in kidney transplant recipients (KTR). We aim to evaluate plasma vitamin C status at different post-transplantation moments and assess the main characteristics associated with vitamin C deficiency in KTR. Methods Plasma vitamin C was assessed in 598 KTR at 3-, 6-, 12-, 24-, and 60-months post-transplantation, 374 late KTR with a functioning graft ≥ 1 year, and 395 potential donors. Vitamin C deficiency was defined as plasma vitamin C ≤ 28 µmol/L. Diet was assessed by a 177-item food frequency questionnaire. Data on vitamin C-containing supplements use were extracted from patient records and verified with the patients. Results Vitamin C deficiency ranged from 46% (6-months post-transplantation) to 30% (≥ 1 year post-transplantation). At all time points, KTR had lower plasma vitamin C than potential donors (30–41 µmol/L vs 58 µmol/L). In cross-sectional analyses of the 953 KTR at their first visit ≥ 12 months after transplantation (55 ± 14 years, 62% male, eGFR 55 ± 19 mL/min/1.73 m 2 ), the characteristics with the strongest association with vitamin C deficiency were diabetes and smoking (OR 2.67 [95% CI 1.84–3.87] and OR 1.84 [95% CI 1.16–2.91], respectively). Dietary vitamin C intake and vitamin C supplementation were associated with lower odds (OR per 100 mg/day 0.38, 95% CI 0.24–0.61 and OR 0.21, 95% CI 0.09–0.44, respectively). Conclusion Vitamin C deficiency is frequent among KTR regardless of the time after transplantation, especially among those with diabetes and active smokers. The prevalence of vitamin C deficiency was lower among KTR with higher vitamin C intake, both dietary and supplemented. Further research is warranted to assess whether correcting this modifiable risk factor could improve survival in KTR.
ISSN:1436-6207
1436-6215
1436-6215
DOI:10.1007/s00394-024-03426-7