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Decreased serum retinol is associated with increased mortality in renal transplant recipients.

Connolly GM, Cunningham R, Maxwell AP, Young IS

Department of Clinical Biochemistry, Royal Victoria Hospital, Belfast, Northern Ireland. Grainne.Connolly@bll.n-i.nhs.uk

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.

Published 21 September 2007 in Clin Chem, 53(10): 1841-6.
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