title: Abnormalities of homocysteine and B vitamins in the nephrotic syndrome.
abstract: BACKGROUND
  The nephrotic syndrome is associated with heightened risk for arterial and venous thrombosis. Multiple derangements of hemostasis and acquired risk factors such as hyperlipidemia and hypertension contribute to this risk. The prevalence in the nephrotic syndrome of high circulating levels of homocysteine and of low levels of the B vitamins that are involved in its metabolism, which may play a role in thrombosis, is not well defined.
  
  
  METHODS
  In 84 patients with nephrotic syndrome and 84 sex- and age-matched controls, hemostasis variables and the circulating levels of total homocysteine (tHcy), vitamin B(6), B(12) and folates were measured.
  
  
  RESULTS
  tHcy levels were higher, vitamin B(6) and vitamin B(12) levels were lower in nephrotic patients than in controls. The association of low vitamin B(6) levels with the nephrotic syndrome was independent of any other alteration associated with the disease. Eighty-two percent of patients with the nephrotic syndrome had vitamin B(6) levels falling in the lowest quartile of the normal distribution. Antithrombin deficiency, factor V Leiden, antiphospholipid antibodies, hypertension, dyslipidemia, were more frequent in patients with the nephrotic syndrome than in controls.
  
  
  CONCLUSIONS
  Patients with the nephrotic syndrome have multiple risk factors for thrombosis. We report that they frequently have low circulating levels of vitamin B(6), which associate with a heightened risk for venous and arterial thrombosis.
authors.affiliation: Centro Emofilia e Trombosi "Angelo Bianchi Bonomi", Dipartmento di Medicina Interna e Dermatologia, Fondazione I.R.C.C.S. Ospedale Maggiore, Mangiagalli e Regina Elena, Università di Milano, Italy.
authors.forename: Gian Marco
authors.initials: GM
authors.lastname: Podda
authors.forename: Federico
authors.initials: F
authors.lastname: Lussana
authors.forename: Gabriella
authors.initials: G
authors.lastname: Moroni
authors.forename: Elena M
authors.initials: EM
authors.lastname: Faioni
authors.forename: Rossana
authors.initials: R
authors.lastname: Lombardi
authors.forename: Gessica
authors.initials: G
authors.lastname: Fontana
authors.forename: Claudio
authors.initials: C
authors.lastname: Ponticelli
authors.forename: Claudio
authors.initials: C
authors.lastname: Maioli
authors.forename: Marco
authors.initials: M
authors.lastname: Cattaneo
mesh_terms: D000328:Adult; D017152:Antibodies, Antiphospholipid / Q000737:chemistry; D000991:Antithrombins / Q000172:deficiency; D005165:Factor V / Q000378:metabolism; D005260:Female; D005492:Folic Acid / Q000378:metabolism; D006710:Homocysteine / Q000378:metabolism*; D006801:Humans; D006949:Hyperlipidemias / Q000175:diagnosis; D006973:Hypertension / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D009404:Nephrotic Syndrome / Q000378:metabolism / Q000473:pathology*; D012306:Risk; D012307:Risk Factors; D014805:Vitamin B 12 / Q000378:metabolism; D025101:Vitamin B 6 / Q000378:metabolism; D014803:Vitamin B Complex / Q000378:metabolism*
chemical_list: D017152:Antibodies, Antiphospholipid; D000991:Antithrombins; C095381:factor V Leiden; D006710:Homocysteine; D014803:Vitamin B Complex; D025101:Vitamin B 6; D005165:Factor V; D005492:Folic Acid; D014805:Vitamin B 12