Korean J Nephrol.  2000 Nov;19(6):1106-1114.

Prevalence and Determinants of Hyperhomocysteinemia in Patients with Chronic Renal Failure

• Choi W
• Kim JK
• Park MJ
• Park BS
• Nah MY
• Yeum CH
• Kim SW
• Choi KC
• Kang YJ

Abstract

BACKGROUND: Hyperhomocysteinemia plays an important role in atherosclerosis resulting from endothelial dysfunction and injury followed by platelet activation and thrombus formation. We evaluated the prevalence and determinants of hyperhomocysteinemia in patients with chronic renal failure(CRF) and relationship between hyperhomocysteinemia and cardiovascular diseases.
METHODS
We evaluated the prevalence of hyperhomocysteinemia in CRF patients and hemodialysis patients. Fasting plasma homocysteine, vitamin B12, vitamin B6, creatinine, fibrinogen, lipoprotein(a), glucose, total cholesterol, HDL cholesterol, and TG levels were assessed in 69 patients.
RESULTS
Hyperhomocysteinemia was detected 5% in controls, 86% in CRF groups, and 85% in hemodialysis group. Serum folate value in hemodialysis group was significantly higher than normal controls (10.7+/-4.8 vs. 15.3+/- 5.4nmoL/L; p<0.05). Plasma homocysteine concentration negatively correlated with serum folate level in hemodialysis patients(r=-0.42, p<0.05). Cardiovascular diseases were deteceted 14% in CRF patients and 25% in hemodialysis patients. Matched odds ratios(with 95% confidence intervals) were respectively 118.75, 107.7 for homocysteine in CRF and hemodialysis patients compaired with control group.
CONCLUSION
Plasma homocysteine level correlated negatively with serum folate level in hemodialysis patients. In univariate analysis, determinant of plasma homocysteine concentration in hemodialysis patients is plasma folate concentration. We considered that hyperhomocysteinemia is also an independent risk factor of cardiovascular diseases.

Keyword

Hyperhomocysteinemia; Cardiovascular disease; Folate level

MeSH Terms

Atherosclerosis
Cardiovascular Diseases
Cholesterol
Cholesterol, HDL
Creatinine
Fasting
Fibrinogen
Folic Acid
Glucose
Homocysteine
Humans
Hyperhomocysteinemia*
Kidney Failure, Chronic*
Lipoprotein(a)
Plasma
Platelet Activation
Prevalence*
Renal Dialysis
Risk Factors
Thrombosis
Vitamin B 12
Vitamin B 6
Cholesterol
Cholesterol, HDL
Creatinine
Fibrinogen
Folic Acid
Glucose
Homocysteine
Lipoprotein(a)
Vitamin B 12
Vitamin B 6