Decreased serum retinol is associated with increased mortality in renal transplant recipients.
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.
Connolly
Grainne M
GM
Department of Clinical Biochemistry, Royal Victoria Hospital, Belfast, Northern Ireland. Grainne.Connolly@bll.n-i.nhs.uk
Cunningham
Ronan
R
Maxwell
A Peter
AP
Young
Ian S
IS
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*
D000975:Antioxidants; D014801:Vitamin A; D002097:C-Reactive Protein