title: Vitamins are associated with survival in patients with end-stage renal disease: a 4-year prospective study.
abstract: BACKGROUND
  Patients with end-stage renal disease are at high risk from premature death due mainly to cardiovascular disease and infections. Established risk factors do not sufficiently explain this increased mortality. We, therefore, investigated total mortality prospectively in a single-centre study in patients on hemodialysis and assessed the prognostic value of baseline disease status, laboratory variables including emerging risk factors, and the influence of vitamin treatment.
  
  
  METHODS
  Patients (n = 102) were followed-up for 4 years or until death (n = 49). Survival was calculated by the Kaplan-Meier method. Cox-proportional hazards model was used to determine independent predictors of total mortality.
  
  
  RESULTS
  The known risk factors age, baseline clinical atherosclerotic disease, low albumin and increased cardiac troponin T were significantly associated with mortality. Patients who received multivitamins during follow-up had a significantly lower mortality risk than those not receiving this treatment (hazard ratio 0.29, 95% confidence interval 0.15-0.56). These associations remained significant after adjustment for age, cardiovascular disease, albumin and cardiac troponin T at baseline.
  
  
  CONCLUSIONS
  The present study suggests that multivitamin supplementation in patients with end-stage renal disease is closely associated with reduced mortality due to all causes. These observations have to be validated in randomized clinical intervention trials.
authors.affiliation: Division of Nephrology, University Hospital Magdeburg, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Domröse
authors.forename: J
authors.initials: J
authors.lastname: Heinz
authors.forename: S
authors.initials: S
authors.lastname: Westphal
authors.forename: C
authors.initials: C
authors.lastname: Luley
authors.forename: K H
authors.initials: KH
authors.lastname: Neumann
authors.forename: J
authors.initials: J
authors.lastname: Dierkes
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D006435:Renal Dialysis; D012307:Risk Factors; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D014815:Vitamins / Q000008:administration & dosage*
chemical_list: D014815:Vitamins