title: Plasma homocysteine and folate levels and dietary folate intake in adolescents and young adults who underwent kidney transplantation during childhood.
abstract: BACKGROUND
  Hyperhomocysteinemia (hyper-Hcy) is an important and reversible cardiovascular disease risk factor. We examined the prevalence of hyper-Hcy, plasma folate levels, and dietary folate intake in adolescents and young adults who had undergone kidney transplantation during childhood to assess the necessity for managing dietary folate.
  
  
  METHODS
  This cross-sectional study was performed in 89 kidney transplant recipients (age at kidney transplantation: 12.6 ± 4.1 years; age during study: 21.2 ± 5.5 years). Hyper-Hcy and plasma folate deficiency were defined as plasma homocysteine (Hcy) >15 nmol/ml and plasma folate <3.0 ng/ml, respectively.
  
  
  RESULTS
  Of the patients, 60 (67.4 %) had hyper-Hcy and 14 (15.7 %) had plasma folate deficiency. Plasma homocysteine levels correlated negatively with estimated glomerular filtration rate (eGFR; r = -0.565, p < 0.01) and plasma folate levels (r = -0.434, p < 0.01). For determinants of plasma homocysteine levels, a priori selected variables included kind of calcineurin inhibitor, age at kidney transplantation, pretransplant duration of dialysis, time since transplantation, age at examination, eGFR, and plasma folate. Stepwise multiple linear regression analysis revealed eGFR and plasma folate levels as significant independent variables influencing plasma homocysteine levels. Dietary folate intake in 11 of 16 patients (66.8 %) with eGFR ≥ 60 ml/min/1.73 m(2) was below the recommended dietary allowance for Japanese.
  
  
  CONCLUSIONS
  The prevalence of hyper-Hcy and plasma folate deficiency, as well as the low dietary folate intake, suggest that dietary management of folate is necessary for adolescents and young adults who have undergone kidney transplantation during childhood.
authors.affiliation: Department of Pediatric Nephrology, School of Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
authors.forename: Ryoko
authors.initials: R
authors.lastname: Hamatani
authors.forename: Miki
authors.initials: M
authors.lastname: Otsu
authors.forename: Hiroko
authors.initials: H
authors.lastname: Chikamoto
authors.forename: Yuko
authors.initials: Y
authors.lastname: Akioka
authors.forename: Motoshi
authors.initials: M
authors.lastname: Hattori
mesh_terms: D000293:Adolescent; D017195:Adolescent Nutritional Physiological Phenomena; D000367:Age Factors; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology; D002648:Child; D002664:Child Nutritional Physiological Phenomena; D003430:Cross-Sectional Studies; D004032:Diet; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage* / Q000097:blood*; D005919:Glomerular Filtration Rate; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D020138:Hyperhomocysteinemia / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D007564:Japan / Q000453:epidemiology; D007668:Kidney / Q000503:physiopathology; D016030:Kidney Transplantation / Q000009:adverse effects; D016014:Linear Models; D008297:Male; D015596:Nutrition Assessment; D009752:Nutritional Status; D015995:Prevalence; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014804:Vitamin B Deficiency / Q000097:blood / Q000453:epidemiology; D055815:Young Adult
chemical_list: D015415:Biomarkers; D006710:Homocysteine; D005492:Folic Acid