Increased plasma homocysteine concentration in patients with chronic renal failure.
Since moderate hyperhomocysteinemia is associated with premature occlusive arterial disease, a frequent complication in uremic patients, we prospectively determined fasting plasma concentration of total homocysteine (Hcy) in 79 nondialyzed patients (47 males) with chronic renal failure. None received folate supplementation. Mean (+/- SD) Hcy concentrations were 16.2 +/- 8.1, 23.3 +/- 14.7 and 29.5 +/- 14.4 mumol/l in patient groups with creatinine clearance (Ccr) of, respectively, 30-75, 10-30 and < 10 ml/min, and significantly higher (p < 0.01) than in 45 healthy controls (8.2 +/- 2.2 mumol/l). Linear regression analysis showed a significant negative correlation between Ccr and Hcy (r = 0.40, p < 0.01). Among 37 male patients aged > or = 50 years, Hcy was significantly higher in 15 who had clinical evidence of occlusive arterial disease than in 22 who did not (28.9 +/- 13.3 vs. 17.8 +/- 8.9 mumol/l, p < 0.01). We conclude that hyperhomocysteinemia is present from the early stage of chronic renal failure and may constitute a risk factor for premature arteriosclerosis in uremic patients.
Chauveau
P
P
Department of Nephrology, Necker Hospital, Paris, France.
Chadefaux
B
B
Coudé
M
M
Aupetit
J
J
Hannedouche
T
T
Kamoun
P
P
Jungers
P
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001157:Arterial Occlusive Diseases / Q000097:blood* / Q000150:complications; D005260:Female; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000150:complications; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D014511:Uremia / Q000097:blood* / Q000209:etiology
D006710:Homocysteine