title: Hyperhomocysteinemia predicts renal function decline: a prospective study in hypertensive adults.
abstract: Hyper-homocysteinemia (HHcy) is associated with microalbuminuria and glomerular injury in general and diabetic populations. However, HHcy's role in hypertensive patients was not studied. We investigated whether HHcy is an independent risk factor for renal function decline and development of chronic kidney disease (CKD) in hypertensive men and women. This was a community-based prospective cohort study of 2,387 hypertensive adults without CKD at baseline, with a mean follow-up of 4.4 years. Baseline and follow-up levels of plasma Hcy, folate, vitamin B12, blood pressure and other pertinent covariables were obtained. CKD was defined as an estimated glomerular filtration rate (eGFR) <60 ml/min/per 1.73 m(2) and an eGFR decline rate >1 ml/min/per 1.73 m(2)/year. There was a graded association between Hcy tertiles and eGFR decline. Subjects in the 3(rd) tertile of Hcy levels had an accelerated rate of eGFR decline and an increased risk of incident CKD, as compared with those in the 1st tertile, after adjusting for age, gender, baseline diabetes, SBP, BMI, smoking, dyslipidemia, eGFR, folate and vitamin B12 levels. In conclusion, in this prospective cohort of Chinese hypertensive adults, elevated baseline plasma Hcy can serve as an independent biomarker to predict renal function decline and incident CKD.
authors.affiliation: National Clinical Research Center of Kidney Disease, State Key Laboratory of Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Di
authors.initials: D
authors.lastname: Xie
authors.affiliation: National Clinical Research Center of Kidney Disease, State Key Laboratory of Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Yuan
authors.affiliation: National Clinical Research Center of Kidney Disease, State Key Laboratory of Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Jiangnan
authors.initials: J
authors.lastname: Guo
authors.affiliation: National Clinical Research Center of Kidney Disease, State Key Laboratory of Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Shenglin
authors.initials: S
authors.lastname: Yang
authors.affiliation: National Clinical Research Center of Kidney Disease, State Key Laboratory of Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Xu
authors.affiliation: National Clinical Research Center of Kidney Disease, State Key Laboratory of Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Qin
authors.initials: Q
authors.lastname: Wang
authors.affiliation: National Clinical Research Center of Kidney Disease, State Key Laboratory of Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Youbao
authors.initials: Y
authors.lastname: Li
authors.affiliation: National Clinical Research Center of Kidney Disease, State Key Laboratory of Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Xianhui
authors.initials: X
authors.lastname: Qin
authors.affiliation: School of Health Administration, Anhui Medical University, Hefei, China.
authors.forename: Genfu
authors.initials: G
authors.lastname: Tang
authors.affiliation: Department of Cardiology, Peking University First Hospital, Beijing, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Huo
authors.affiliation: National Clinical Research Center of Kidney Disease, State Key Laboratory of Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Guangpu
authors.initials: G
authors.lastname: Deng
authors.affiliation: National Clinical Research Center of Kidney Disease, State Key Laboratory of Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Shengjie
authors.initials: S
authors.lastname: Wu
authors.affiliation: National Clinical Research Center of Kidney Disease, State Key Laboratory of Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China.|Institute of Biomedicine, Anhui Medical University, Hefei, China.
authors.forename: Binyan
authors.initials: B
authors.lastname: Wang
authors.affiliation: National Clinical Research Center of Kidney Disease, State Key Laboratory of Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Qin
authors.initials: Q
authors.lastname: Zhang
authors.affiliation: Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, USA.
authors.forename: Xiaobin
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Pharmacology, Center for Metabolic Disease Research, Temple University School of Medicine, Philadelphia, Pennsylvania, USA.
authors.forename: Pu
authors.initials: P
authors.lastname: Fang
authors.affiliation: Department of Pharmacology, Center for Metabolic Disease Research, Temple University School of Medicine, Philadelphia, Pennsylvania, USA.
authors.forename: Hong
authors.initials: H
authors.lastname: Wang
authors.affiliation: National Clinical Research Center of Kidney Disease, State Key Laboratory of Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Xiping
authors.initials: X
authors.lastname: Xu
authors.affiliation: National Clinical Research Center of Kidney Disease, State Key Laboratory of Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Fanfan
authors.initials: F
authors.lastname: Hou
mesh_terms: D000368:Aged; D001794:Blood Pressure; D015331:Cohort Studies; D003710:Demography; D005260:Female; D005492:Folic Acid / Q000097:blood; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006710:Homocysteine / Q000097:blood; D006801:Humans; D020138:Hyperhomocysteinemia / Q000150:complications / Q000175:diagnosis*; D006973:Hypertension / Q000150:complications / Q000175:diagnosis*; D007668:Kidney / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000209:etiology*; D012307:Risk Factors; D014805:Vitamin B 12 / Q000097:blood
chemical_list: D006710:Homocysteine; D005492:Folic Acid; D014805:Vitamin B 12