title: Positive association between plasma homocysteine level and chronic kidney disease.
abstract: BACKGROUND
  Increasing experimental evidence, including recently developed animal models, supports a role for homocysteine in the development of chronic kidney disease (CKD). However, relatively few clinical/epidemiological studies have examined this hypothesis in humans. We examined the relationship between plasma homocysteine level and CKD in a population-based study of older Australians.
  
  
  METHODS
  Community-based study (1992-1994) among 2,609 individuals (58.6% women), aged 49-98 years, free of clinical cardiovascular disease in the Blue Mountains region, west of Sydney, Australia. The main outcome-of-interest was CKD (n = 461), defined as estimated glomerular filtration rate of <60 ml/min/1.73 m(2).
  
  
  RESULTS
  Higher plasma homocysteine levels were positively associated with CKD, independent of smoking, body mass index, diabetes mellitus, hypertension, cholesterol levels, and other confounders. The multivariable odds ratio (OR; 95% confidence intervals, CI) comparing quartile 4 of plasma homocysteine (>14 micromol/l) to quartile 1 (< or =9 micromol/l) was 10.44 (6.99-15.60), p-trend <0.0001. This association persisted in both men and women separately. The results were also consistent in subgroup analyses by categories of diabetes mellitus and hypertension.
  
  
  CONCLUSIONS
  Higher plasma homocysteine levels are associated with CKD in a community-based sample of older Australians. This association appeared to be independent of diabetes mellitus and hypertension.
authors.affiliation: Division of Epidemiology, Department of Community, Occupational, and Family Medicine, National University of Singapore, Singapore. ashankar@nus.edu.sg
authors.forename: Anoop
authors.initials: A
authors.lastname: Shankar
authors.forename: Jie Jin
authors.initials: JJ
authors.lastname: Wang
authors.forename: Brian
authors.initials: B
authors.lastname: Chua
authors.forename: Elena
authors.initials: E
authors.lastname: Rochtchina
authors.forename: Vicki
authors.initials: V
authors.lastname: Flood
authors.forename: Paul
authors.initials: P
authors.lastname: Mitchell
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000453:epidemiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012737:Sex Factors
chemical_list: D015415:Biomarkers; D006710:Homocysteine