Hyperhomocysteinemia in chronic renal failure: alternative therapeutic strategies.
Chronic renal failure and uremia represent states wherein high blood levels of homocysteine, a cardiovascular risk factor, are largely resistant to folate therapy. Indeed, normalization of homocysteine levels through vitamin administration is rarely achieved in this population, and this fact could explain, among other causes, the negative results of intervention trials designed to lower cardiovascular risk. Dialysis itself lowers homocysteine levels, albeit transitorily. N-acetylcysteine therapy could induce an additional decrease in homocysteine removal during dialysis, thus representing an alternative approach in the attempt to lower cardiovascular risk in these patients.
First Division of Nephrology, Department of Cardiothoracic and Respiratory Sciences, Second University of Medicine, via Pansini 5, Naples, Italy. alessandra.perna@unina2.it
Alessandra F
AF
Perna
Immacolata
I
Sepe
Diana
D
Lanza
Rosa Maria
RM
Pollastro
Natale G
NG
De Santo
Diego
D
Ingrosso
D000111:Acetylcysteine / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000209:etiology; D004351:Drug Resistance; D005492:Folic Acid / Q000627:therapeutic use; D006801:Humans; D020138:Hyperhomocysteinemia / Q000150:complications* / Q000188:drug therapy*; D007676:Kidney Failure, Chronic / Q000150:complications*; D006435:Renal Dialysis; D012307:Risk Factors
D005492:Folic Acid; D000111:Acetylcysteine