Serum total homocysteine concentration before and after renal transplantation

Arnadottir, Margret; Hultberg, Björn; Wahlberg, Jan; Fellström, Bengt; Dimény, Emöke

doi:10.1046/j.1523-1755.1998.00112.x

Cited by 77 publications

(46 citation statements)

References 15 publications

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“…This finding agrees with other studies. 8,[12][13][14][15] In our study, even within their normal range, tHcy were negative and significantly correlated with folic acid and vitamin B 12 concentrations. However, it is unlikely that elevated levels of tHcy are attributable to deficiencies of these vitamins, because RT patients can have a regular diet without the restrictions that characterize dialysis patients.…”

Section: Discussionmentioning

confidence: 84%

Hyperhomocysteinemia in renal transplantation: preliminary results

Fonseca

Queirós

Santos

et al. 2000

Transplantation Proceedings

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C ARDIOVASCULAR disease (CVD) is a major cause of morbidity and mortality after renal transplantation (RT). 1,2 The excess risk of CVD in RT is due in part to a higher prevalence of established atherosclerotic risk factors, including hypertension, dyslipidemia, diabetes, obesity, and physical inactivity. 1,2 However, some renal-related risk factors like immunosuppressive medication and residual renal insufficiency also contribute to this excess CVD risk and may complicate the management of dyslipidemia and hypertension in this population. 1,2 Accordingly, there is a compelling need to identify and safely manage other putative CVD risk factors among RT patients. Elevated plasma homocysteine is emerging as an important risk factor for cardiovascular disease in general populations. 3,4 Some studies have demonstrated that hyperhomocysteinemia is present in patients with impaired renal function and is associated with CVD. 5-7 Only a small number of studies are available on the prevalence and determinants of hyperhomocysteinemia in renal transplant recipients. 8 -15 We undertook this study to 1. estimate the prevalence of hyperhomocysteinemia in renal transplant recipients; 2. examine the relationships between plasma total homocysteine (tHcy) and its metabolic determinants vitamin B 6 , vitamin B 12 , and folic acid; and 3. identify other determinants of tHcy. MATERIALS AND METHODSA cross-sectional study was conducted in 202 stable RT recipients (113 male, 89 female), selected from 633 RT patients with functioning allografts of our Renal Transplant Unit. All recipients received grafts from cadaver donors. The eligibility criteria were: age over 18 years, first renal allograft, time since RT of at least 6 months, and stable plasma creatinine values during 3 months prior to study. Patients with diagnosis of any kind of cancer, clinical or analytical evidence of liver disease, and chronic alcoholism were also excluded. None of the selected RT recipients were taking B vitamin.The mean age was 44 Ϯ 11 years (range, 21 to 71; median, 43). The mean duration after renal transplantation was 58.5 Ϯ 37.2 months (range, 17 to 192; median, 50.6). Patients had been on dialysis for an average of 42.7 Ϯ 37.5 months (range, 0 to 221; median, 30.5) before transplantation. Mean serum creatinine value was 1.5 Ϯ 0.6 mg/dL (range, 0.6 to 4.7; median, 1.4) at the time blood was drawn for this study. Immunosuppression protocol of the 202 RT patients is described on Table 1.The Ethics Committee of Santo Antonio Hospital approved the study protocol, and all participants provided written informed consent. Biochemical DeterminationsOvernight fasting blood samples were collected from each participant. Total fasting homocysteine levels were determined by polarized immunofluorescence on an automated Abbott IMx analyzer. Hyperhomocysteinemia was considered if plasma levels of fasting tHcy were higher than 15 mol/L. Plasma pyridoxal 5Ј-phosphate was determined by high performance liquid chromatography with fluorescence detection. Plasma vitamin B 12...

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Section: Discussionmentioning

confidence: 84%

Hyperhomocysteinemia in renal transplantation: preliminary results

Fonseca

Queirós

Santos

et al. 2000

Transplantation Proceedings

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“…31,33 After renal transplantation, as many as 29% of patients will have an increase in Hcy correlating with the degree of renal impairment and folate levels. [34][35][36][37] Immunosuppressive medications such as azathioprine, prednisone, and tacrolimas do not appear to affect Hcy in either cardiac or renal transplant patients. 33,38,39 Cyclosporin is associated with elevated Hcy in heart transplants, but the data in renal transplants are conflicting.…”

Section: Etiology Of Hyperhomocysteinemiamentioning

confidence: 99%

The association of homocysteine and coronary artery disease

Gauthier¹,

Keevil²,

McBride³

2003

Clinical Cardiology

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Summary: Hyperhomocysteinemia has been associated with increased risk of atherosclerosis and myocardial infarction by a number of prospective case-control studies. A variety of genetic mutations, nutritional deficiencies, disease states, and drugs can elevate homocysteine concentrations. Treatment with folic acid with or without B-complex vitamins effectively lowers homocysteine levels. Whether therapy corresponds with decreased risk of coronary events is unknown, but may be promising. This article reviews the biochemistry of homocysteine metabolism, pathogeneisis, and etiology of hyperhomocysteinemia, along with its association with coronary artery disease, screening, and treatment.

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“…Factors associated with hyperhomocysteinemia are age, smoking, systemic arterial hypertension, folate and vitamin B12 levels, elevated cholesterol, sedentary lifestyle and, especially, renal function 3,7,[14][15][16][17][18][19][20] . Some studies have shown that there is no correlation between blood cyclosporine and Hcy levels 11,15,17 .…”

Section: Introductionmentioning

confidence: 99%

“…Some studies have shown that there is no correlation between blood cyclosporine and Hcy levels 11,15,17 .…”

Section: Introductionmentioning

confidence: 99%