title: Hyperhomocysteinemia and assessment of its associated factors in renal transplant recipients: a single-center study in northern Iran.
abstract: BACKGROUND
  Hyperhomocysteinemia (hyperHcy) is an important risk factor for atherosclerosis, which is currently a major cause of death in renal transplant patients (RTRs). The aim of this study was to determine the associated factors of hyperHcy in RTRs in northern Iran.
  
  
  METHODS
  In 148 stable RTRs, total serum homocysteine (tHcy) level, folate, serum albumin and creatinine, creatinine clearance, lipid status, body mass index (BMI), and blood cyclosporine levels (C0 and C2) were determined. The mean doses of cyclosporine A (mg/kg/day) were recorded.
  
  
  RESULTS
  In this analytic cross-sectional study the prevalence of hyperHcy was 70.3%. Hyperhomocysteinemia was defined as total serum homocysteine of 12 μmol/L or greater. The comparison of the group of 44 patients with tHcy level less than 12 and the group of 104 patients with tHcy level of 12 μmol/L or greater revealed that those subjects with hyperHcy were mostly younger, male, with lower BMI, history of glomerulonephritis, higher serum level of uric acid, and blood cyclosporine trough level (C0) and used higher doses of cyclosporine A. Significant correlation was found between tHcy level and recipients age, serum creatinine, BUN, folate concentrations, and creatinine clearance. However, multivariate analysis indicated that serum folate (P=0.01), vitamin B12 (P=0.05), creatinine (P=0.03), and BUN (P=0.05), and blood cyclosporine trough level (C0, P=0.005) were independently associated with tHcy levels.
  
  
  CONCLUSIONS
  HyperHcy persists after successful kidney transplantation in the majority of RTRs. Serum creatinine, BUN, folate and vitamin B12, and blood cyclosporine trough level (C0) are independently associated with tHcy levels.
authors: 1 Urology Research Center, School of Medical, Guilan University of Medical Sciences, Rasht, Iran. 2 School of Medicine, Guilan University of Medical Sciences, Rasht, Iran. 3 Address correspondence to: Seyyede Zeinab Azimi, M.D., Urology Research Center, School of Medical, Guilan University of Medical Sciences, Department of Nephrology, Razi Hospital, Rasht, Iran.
authors: Ali
authors: A
authors: Monfared
authors: Seyyede Zeinab
authors: SZ
authors: Azimi
authors: Ehsan
authors: E
authors: Kazemnezhad
authors: Masoud
authors: M
authors: Khosravi
authors: Mohammadkazem
authors: M
authors: Lebadi
authors: Ebrahim
authors: E
authors: Mirzajani
authors: Mohammad Najafi
authors: MN
authors: Ashtiani
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D001806:Blood Urea Nitrogen; D016009:Chi-Square Distribution; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D016572:Cyclosporine / Q000097:blood / Q000627:therapeutic use; D005260:Female; D005492:Folic Acid / Q000097:blood; D006710:Homocysteine / Q000097:blood; D006801:Humans; D020138:Hyperhomocysteinemia / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D007166:Immunosuppressive Agents / Q000097:blood / Q000627:therapeutic use; D007492:Iran / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D016030:Kidney Transplantation; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D012307:Risk Factors; D013997:Time Factors; D014805:Vitamin B 12 / Q000097:blood
chemical_list: D015415:Biomarkers; D007166:Immunosuppressive Agents; D006710:Homocysteine; D016572:Cyclosporine; D005492:Folic Acid; D003404:Creatinine; D014805:Vitamin B 12