Plasma total homocysteine and folate concentration in patients with chronic renal failure and renal transplant recipients

Kim, Beom; Ha, Kyoung Won; Lee, Yoon Ha; Kim, Hye Young; Huh, Wooseong; Kim, Dae Joong; Kim, Yoon Goo; Oh, Ha Young

Abstract

BACKGROUND: A few articles reported that the plasma total homocysteine(tHcy) concentration of renal transplant recipients(RTR) was higher than that of normal controls, but lower than that of patients with chronic renal failure. But renal function of the RTR was variable, and plasma tHcy concentration of RTR with normal renal function was unknown. We compared plasma tHcy concentration of RTR with normal renal function to normal controls and evaluated the relation between folate concentration, the independent factor of plasma tHcy concentration, and plasma tHcy in patients with chronic renal failure in predialysis, hemodialysis(HD) and continuous ambulatory peritoneal dialysis(CAPD).
METHODS
We measured fasting plasma level of total homocysteine by high-performance liquid chromatography and folate concentration in 36 predialysis CRF patients(Ccr<25mL/min), 37 HD patients, 28 CAPD patients, 41 RTR(serum creatinine< or =1.4mg/dL) and 37 healthy controls.
RESULTS
1)Mean(+/-SD) tHcy concentration in predialysis CRF(21.93+/-14.33micromol/L), HD(18.24+/-8.73micromol /L) and CAPD(17.16+/-7.8micromol/L) patients was significantly higher than that in controls (8.91+/-4.11micromol/L, P<0.05) but tHcy concentration of RTR group(8.99+/-3.99micromol/L)had no difference from that of normal controls 2)In predialysis patients, CAPD patients, and HD patients showed a significant negative correlation between serum folate and plasma tHcy concentrations (r=-0.18, p<0.05). 3)In predialysis, HD and CAPD patients, mean plasma folate concentration in patients with 1mg/ day-folate supplementation(20.41+/-15.65ng/mL) was higher than patients without 1mg/day-folate supplementation (10.20+/-8.24ng/mL)(p<0.05) and mean plasma tHcy concentration in patients with 1mg/day-folate supplementation (17.87+/- 7.94micromol/L) was lower than patients without 1mg/day-folate supplementation(21.87+/-13.35micromol/L)(p<0.05).
CONCLUSION
Plasma tHcy concentration in RTR with normal renal function had no difference with that in normal controls. In predialysis, HD, and CAPD patients, plasma tHcy had negative correlation with plasma folate concentration and plasma tHcy in patients with 1mg folate supplementation, usual dose in chronic renal failure, was higher than that in patients without folate supplementation and lower than that in normal controls.