The influence of estimated creatinine clearance on plasma homocysteine in hypertensive patients with normal serum creatinine.
OBJECTIVE
To examine the relation of estimated creatinine clearance (eCrCl) and plasma total homocysteine (tHcy) in hypertensive patients with a normal serum creatinine level.


METHODS
A total of 137 hypertensive patients (mean age 66.6 years, 69 men) with serum creatinine level </=1.5 mg/dL gave 10-h fasting blood samples for measurement of tHcy, serum folic acid, and serum vitamin B(12).


RESULTS
95 patients fell into a chronic renal insufficiency (CRI) group (eCrCl< or =60 mL/min/1.73 m(2)) and 42 into a normal renal function (NRF) group (eCrCl>60 mL/min/1.73 m(2)). The CRI group was older (p<0.001), had higher tHcy (p<0.001), higher serum urea nitrogen (p<0.001), higher serum creatinine (p<0.001), lower eCrCl (p<0.001), and lower diastolic blood pressure (p=0.001). In univariate analysis, eCrCl had the strongest correlation with tHcy (r=-0.453, p<0.001). Significant correlations, ranging in decreasing order from r=-0.418, p<0.001 to r=-0.170, p=0.047, were also noted between tHcy and twelve other variables. In multivariate analysis, only eCrCl (p<0.001), usage of fibrate (p<0.001), serum level of vitamin B(12) (p=0.002), serum level of folic acid (p=0.009), and smoking (p=0.027) were independent predictors of tHcy.


CONCLUSIONS
eCrCl is a strong independent predictor of tHcy in hypertensive patients with normal serum creatinine.
Lin
Yen-Hung
YH
Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin, Taiwan.
Pao
Kuan-Yin
KY
Wu
Vin-Cent
VC
Lin
Yu-Li
YL
Chien
Yu-Fen
YF
Hung
Chi-Sheng
CS
Chen
Yu-Jen
YJ
Liu
Chung-Pin
CP
Tsai
I-Jung
IJ
Gau
Churn-Shiouh
CS
Wu
Kwan-Dun
KD
Hwang
Juey-Jen
JJ
D000368:Aged; D015415:Biomarkers / Q000097:blood / Q000652:urine; D003404:Creatinine / Q000097:blood / Q000652:urine*; D005260:Female; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D006973:Hypertension / Q000150:complications*; D007674:Kidney Diseases / Q000175:diagnosis* / Q000209:etiology; D008297:Male
D015415:Biomarkers; D006710:Homocysteine; D003404:Creatinine