ผลของการรักษาด้วยแสงยูวีบีต่อระดับวิตามินดีในผู้ป่วยปลูกถ่ายไต

Abstract

Background: The prevalence of hypovitamin D in post kidney transplantation patient is high and causes morbidity and mortality. Vitamin D is synthesized by sun exposure. The objective of this study is to evaluate the effect of UVB therapy compared with oral vitamin D in post transplant recipients. Methods: Forty post kidney transplant recipients who had 25(OH)D concentration less than 30 ng/ml were enrolled and randomized into 2 groups, Group 1 received UVB, accumulation dose of 6,952 mJ/cm2 within 3 weeks. Group 2 receives oral vitamin D, total dose of 120,000 IU within 7 weeks. 25(OH)D, serum calcium, phosphorus, iPTH were measured before and after treatment. Results: Vitamin D deficiency of kidney transplant recipients had 17.5% DM. Fifty percent of vitamin D deficiencient cases received corticosteroid for rejection prevention. In UVB group, 25(OH)D was significantly increased (P<0.001) at 3th week and at 7th week after therapy. Serum calcium and phosphorus were also significantly increased (P<0.04 and P<0.03 respectively) at 7th week after therapy. In oral vitamin D group, 25(OH)D significantly increased (P<0.001) within 8th week after therapy. In this group they were not statistic significant of serum calcium and serum phosphorous before and after therapy (P>0.05). Serum iPTH of both groups was not significantly changed (P>0.05). The adverse event of UVB therapy was itching (33.3%), hyperpigmentation (27.7%) and no hypercalcemic event. Conclusion: UVB exposure increases 25(OH)D. Its efficacy was compared to oral vitamin D. inadequate sun exposure and corticosteroid use were risk factors of hypovitamin D in post kidney transplant recipients.