title: Decreased serum retinol is associated with increased mortality in renal transplant recipients.
abstract: BACKGROUND
  Vitamin A plays a central role in epithelial integrity and immune function. Given the risk of infection after transplantation, adequate vitamin A concentrations may be important in patients with a transplant. We assessed whether there was an association between retinol concentration and all-cause mortality in renal transplant recipients.
  
  
  METHODS
  We recruited 379 asymptomatic renal transplant recipients between June 2000 and December 2002. We measured serum retinol at baseline and collected prospective follow-up data at a median of 1739 days.
  
  
  RESULTS
  Retinol was significantly decreased in those renal transplant recipients who had died at follow-up compared with those who were still alive at follow-up. Kaplan-Meier analysis showed that retinol concentration was a significant predictor of mortality. In multivariate Cox regression analysis, decreased retinol concentration remained a statistically significant predictor of all-cause mortality after adjustment for traditional cardiovascular risk factors, high-sensitivity C-reactive protein, and estimated glomerular filtration rate.
  
  
  CONCLUSIONS
  Serum retinol concentration is a significant independent predictor of all-cause mortality in renal transplantation patients. Higher retinol concentration might impart a survival advantage via an antiinflammatory or anti-infective mechanism.
authors: Department of Clinical Biochemistry, Royal Victoria Hospital, Belfast, Northern Ireland. Grainne.Connolly@bll.n-i.nhs.uk
authors: Grainne M
authors: GM
authors: Connolly
authors: Ronan
authors: R
authors: Cunningham
authors: A Peter
authors: AP
authors: Maxwell
authors: Ian S
authors: IS
authors: Young
mesh_terms: D000975:Antioxidants / Q000032:analysis*; D002097:C-Reactive Protein / Q000032:analysis; D004032:Diet; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D053208:Kaplan-Meier Estimate; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009026:Mortality; D016011:Normal Distribution; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D044967:Serum; D014801:Vitamin A / Q000097:blood*
chemical_list: D000975:Antioxidants; D014801:Vitamin A; D002097:C-Reactive Protein