Homocysteine metabolism in children with idiopathic nephrotic syndrome.
BACKGROUND
Homocysteine metabolism is altered in children with idiopathic nephrotic syndrome. Hyperhomocysteinemia is a risk factor of early atherosclerosis and glomerulosclerosis and may occur at time of first occurrence of idiopathic nephrotic syndrome.


METHODS
Thirty children with first episode of idiopathic nephrotic syndrome (FENS) aged 1-16 years along with 30 age- and sex-matched healthy controls were enrolled in this study. Homocysteine and cysteine were measured with HPLC; vitamin B12 and folic acid were measured with electro-chemilumiscence immunoassay. Primary outcome measure was plasma homocysteine level in children with FENS and in controls. Secondary outcome measures were (1) plasma and urine homocysteine and cysteine levels in children with FENS at 12 weeks and 1 year (remission) and (2) plasma and urine levels of vitamin B12 and folic acid in children with FENS, at 12 weeks and 1 year (remission).


RESULTS
Plasma homocysteine and cysteine levels were comparable to controls in children with FENS, at 12 weeks and 1-year remission. Plasma levels of vitamin B12 and folic acid were significantly decreased compared to controls in FENS due to increased urinary excretion, which normalize during remission at 12 weeks and 1 year. Urinary homocysteine and cysteine levels were significantly raised in FENS compared to controls and continued to be raised even at 12-week and 1-year remission.


CONCLUSIONS
Homocysteine metabolism is deranged in children with FENS. Renal effects of long-term raised urinary homocysteine levels need to be studied.
Division of Pediatric Nephrology, Department of Pediatrics, Postgraduate Institute of Medical Education and Research associated Dr. Ram Manohar Lohia Hospital, New Delhi, India.
Mohan
M
Kundal
Abhijeet
A
Saha
N K
NK
Dubey
Kanika
K
Kapoor
Trayambak
T
Basak
Gaurav
G
Bhardwaj
Vinay Singh
VS
Tanwar
Shantanu
S
Sengupta
Vinita
V
Batra
Ashish Dutt
AD
Upadhayay
Ajay
A
Bhatt
D016022:Case-Control Studies; D002648:Child; D002784:Cholesterol / Q000097:blood; D003545:Cysteine / Q000097:blood / Q000652:urine; D003710:Demography; D005260:Female; D005492:Folic Acid / Q000097:blood; D006710:Homocysteine / Q000097:blood / Q000378:metabolism*; D006801:Humans; D008297:Male; D009404:Nephrotic Syndrome / Q000097:blood / Q000378:metabolism* / Q000652:urine; D011507:Proteinuria / Q000097:blood; D012074:Remission Induction; D012709:Serum Albumin / Q000378:metabolism; D014805:Vitamin B 12 / Q000097:blood
D012709:Serum Albumin; D006710:Homocysteine; D005492:Folic Acid; D002784:Cholesterol; D003545:Cysteine; D014805:Vitamin B 12
children; homocysteine; nephrotic syndrome