{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T23:01:36Z","timestamp":1767826896256,"version":"3.49.0"},"reference-count":40,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2017,6,2]],"date-time":"2017-06-02T00:00:00Z","timestamp":1496361600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Vitamin C may reduce inflammation and is inversely associated with mortality in the general population. We investigated the association of plasma vitamin C with all-cause mortality in renal transplant recipients (RTR); and whether this association would be mediated by inflammatory biomarkers. Vitamin C, high sensitive C-reactive protein (hs-CRP), soluble intercellular cell adhesion molecule 1 (sICAM-1), and soluble vascular cell adhesion molecule 1 (sVCAM-1) were measured in a cohort of 598 RTR. Cox regression analyses were used to analyze the association between vitamin C depletion (\u226428 \u00b5mol\/L; 22% of RTR) and mortality. Mediation analyses were performed according to Preacher and Hayes\u2019s procedure. At a median follow-up of 7.0 (6.2\u20137.5) years, 131 (21%) patients died. Vitamin C depletion was univariately associated with almost two-fold higher risk of mortality (Hazard ratio (HR) 1.95; 95% confidence interval (95%CI) 1.35\u20132.81, p &lt; 0.001). This association remained independent of potential confounders (HR 1.74; 95%CI 1.18\u20132.57, p = 0.005). Hs-CRP, sICAM-1, sVCAM-1 and a composite score of inflammatory biomarkers mediated 16, 17, 15, and 32% of the association, respectively. Vitamin C depletion is frequent and independently associated with almost two-fold higher risk of mortality in RTR. It may be hypothesized that the beneficial effect of vitamin C at least partly occurs through decreasing inflammation.<\/jats:p>","DOI":"10.3390\/nu9060568","type":"journal-article","created":{"date-parts":[[2017,6,2]],"date-time":"2017-06-02T10:20:44Z","timestamp":1496398844000},"page":"568","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Vitamin C Depletion and All-Cause Mortality in Renal Transplant Recipients"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6835-6386","authenticated-orcid":false,"given":"Camilo G.","family":"Sotomayor","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen 9700 RB, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele F.","family":"Eisenga","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen 9700 RB, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio W.","family":"Gomes Neto","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen 9700 RB, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akin","family":"Ozyilmaz","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen 9700 RB, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rijk O.B.","family":"Gans","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen 9700 RB, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wilhelmina H.A. de","family":"Jong","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen 9700 RB, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dorien M.","family":"Zelle","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen 9700 RB, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan P.","family":"Berger","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen 9700 RB, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlo A. J.M.","family":"Gaillard","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen 9700 RB, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3356-6791","authenticated-orcid":false,"given":"Gerjan J.","family":"Navis","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen 9700 RB, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephan J.L.","family":"Bakker","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen 9700 RB, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2017,6,2]]},"reference":[{"key":"ref_1","first-page":"86","article-title":"Cost Comparison Haemodialysis and Renal Transplantation","volume":"7","author":"Schippers","year":"1976","journal-title":"HLA"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1038\/ki.1996.307","article-title":"A Study of the Quality of Life and Cost-Utility of Renal Transplantation","volume":"50","author":"Laupacis","year":"1996","journal-title":"Kidney Int."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1053\/ajkd.1998.v32.pm9669429","article-title":"Changes in Quality of Life After Renal Transplantation","volume":"32","author":"Jofre","year":"1998","journal-title":"Am. 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