Association of serum vitamin B levels with all-cause and cardiovascular mortality in hemodialysis patients

Abstract Background: Patients on hemodialysis (HD) are prone to having vitamin B metabolic disorders, though impact of changes in serum vitamin B concentrations on patients’ survival remains unknown. This study is to investigate the association of serum vitamin B1, B3, B5, and B6 levels with all-cause mortality and cardiovascular mortality in HD patients.Methods: This is a prospective observational study conducted in the HD center of Peking University People's Hospital. At baseline, demographic and clinical characteristics of HD patients were collected, and pre-dialysis serum vitamin B1, B3, B5, and B6 levels were measured by high performance liquid chromatography- tandem mass spectrometry (HPLC-MS/MS) method. Patients were prospectively followed up for the occurrence of endpoint including all-cause and cardiovascular (CV) death. Survival curves were estimated by using Kaplan-Meier analysis. Cox proportional hazards regression analysis was used to examine the association of serum vitamin B1, B3, B5, and B6 with all-cause mortality and CV mortality.Results: Seventy-six HD patients were included. The incidences of vitamin B1, B3, B5, and B6 deficiencies were 86.8%, 23.7%, 97.4%, and 35.5%, respectively. The median follow-up time was 99(range 6 to 101) months. During follow-up, 28(36.8%) patients died, 19(25.0%) of them were due to CV diseases. Kaplan-Meier analysis showed that baseline vitamin B5＜69.0 nmol/l and vitamin B6＜8.1 ng/ml were associated with a higher risk of CV mortality (P=0.039 and 0.048). However, these associations were nullified after adjustment.Conclusions: Serum vitamin B1, B3, B5 and B6 concentrations were not associated with all-cause mortality or CV mortality in HD patients.