@article{EspeRailaHenzeetal.2011,
  author    = {Espe, Katharina M. and Raila, Jens and Henze, Andrea and Krane, Vera and Schweigert, Florian J. and Hocher, Berthold and Wanner, Christoph and Drechsler, Christiane},
  title     = {Impact of vitamin A on clinical outcomes in haemodialysis patients},
  series = {Nephrology, dialysis, transplantation},
  volume    = {26},
  journal   = {Nephrology, dialysis, transplantation},
  number    = {12},
  publisher = {Oxford Univ. Press},
  address   = {Oxford},
  organization    = {German Diabetes \& Dialysis Study I},
  issn      = {0931-0509},
  doi       = {10.1093/ndt/gfr171},
  pages     = {4054 -- U583},
  year      = {2011},
  abstract  = {Background. Patients on maintenance haemodialysis treatment experience an excessive risk of cardiovascular disease and mortality. The vitamin A concentration is known to be higher in these patients compared to the general population where elevated vitamin A concentrations are associated with adverse outcome. The impact of vitamin A on morbidity and mortality in end-stage renal disease patients is controversial and is the topic of this study. Methods. We analysed plasma retinol and retinol-binding protein 4 (RBP4) in 1177 diabetic haemodialysis patients, who participated in the German Diabetes and Dialysis Study (median follow-up 4 years). By Cox regression analyses hazard ratios (HRs) were determined for pre-specified, adjudicated end points according to baseline concentrations. Results. Patients had a mean age of 66 +/- 8 years, mean retinol and RBP4 concentrations of 3.28 (0.71-7.44) and 4.02 (1.28-10.1) mu mol/L, respectively. Patients with retinol concentrations in the first quartile (<2.6 mu mol/L) had an almost 2-fold increased risk of all-cause mortality compared to patients of the fourth quartile [>3.9 mu mol/L; HR 1.81, 95\% confidence interval (CI) 1.43-2.30]. There was a strong association between low retinol and the risk of sudden cardiac death (SCD, HR 2.22, 95\% CI 1.41-3.50) and fatal infection (HR 2.19, 95\% CI 1.26-3.82). Patients with RBP4 concentrations in the lowest quartile (<3.0 mu mol/L) were more likely to die of any cause (HR 1.43, 95\% CI 1.14-1.80), experience SCD (HR 1.97, 95\% CI 1.28-3.03) and cardiovascular events (HR 1.43, 95\% CI 1.10-1.85). Conclusion. This large cohort study shows a strong association of low retinol and RBP4 concentrations with SCD and all-cause mortality in diabetic haemodialysis patients.},
  language  = {en}
}
@article{HenzeRailaKempfetal.2011,
  author    = {Henze, Andrea and Raila, Jens and Kempf, Caroline and Reinke, Petra and Sefrin, Anett and Querfeld, Uwe and Schweigert, Florian J.},
  title     = {Vitamin A metabolism is changed in donors after living-kidney transplantation an observational study},
  series = {Lipids in health and disease},
  volume    = {10},
  journal   = {Lipids in health and disease},
  number    = {23},
  publisher = {BioMed Central},
  address   = {London},
  issn      = {1476-511X},
  doi       = {10.1186/1476-511X-10-231},
  pages     = {7},
  year      = {2011},
  abstract  = {Background: The kidneys are essential for the metabolism of vitamin A (retinol) and its transport proteins retinol-binding protein 4 (RBP4) and transthyretin. Little is known about changes in serum concentration after living donor kidney transplantation (LDKT) as a consequence of unilateral nephrectomy; although an association of these parameters with the risk of cardiovascular diseases and insulin resistance has been suggested. Therefore we analyzed the concentration of retinol, RBP4, apoRBP4 and transthyretin in serum of 20 living-kidney donors and respective recipients at baseline as well as 6 weeks and 6 months after LDKT. Results: As a consequence of LDKT, the kidney function of recipients was improved while the kidney function of donors was moderately reduced within 6 weeks after LDKT. With regard to vitamin A metabolism, the recipients revealed higher levels of retinol, RBP4, transthyretin and apoRBP4 before LDKT in comparison to donors. After LDKT, the levels of all four parameters decreased in serum of the recipients, while retinol, RBP4 as well as apoRBP4 serum levels of donors increased and remained increased during the follow-up period of 6 months. Conclusion: LDKT is generally regarded as beneficial for allograft recipients and not particularly detrimental for the donors. However, it could be demonstrated in this study that a moderate reduction of kidney function by unilateral nephrectomy, resulted in an imbalance of components of vitamin A metabolism with a significant increase of retinol and RBP4 and apoRBP4 concentration in serum of donors.},
  language  = {en}
}