Hyperhomocysteinemia increases the risk of chronic kidney disease in a Chinese middle-aged and elderly population-based cohort.
BACKGROUND
Patients either with hyperhomocysteinemia or chronic kidney disease (CKD) have an increased risk of cardiovascular disease. Little is known regarding whether hyperhomocysteinemia can increase the risk of CKD in a Chinese middle-aged and elderly population. To help clarify this we conducted a prospective cohort study to measure the association of hyperhomocysteinemia with CKD.


METHODS
A total of 5917 adults aged 56.4 ± 9.6 years without CKD at baseline were enrolled. The highest homocysteine quartile (≥15 μmol/L) was defined as hyperhomocysteinemia. CKD was defined as decreased estimated glomerular filtration rate (eGFR < 60 mL/min/1.73 m2) or presence of proteinuria (urine protein ≥ 1+) assessed using a repeated dipstick method.


RESULTS
During 3 years of follow-up, 143 (2.4%) patients developed CKD, 85 (1.4%) patients with proteinuria and 59 (1.0%) patients with decreased eGFR. After adjusted for potential confounders, both homocysteine (per 1 μmol/L increase) and hyperhomocysteinemia were independently associated with increased risk of decreased eGFR [with a fully adjusted OR of 1.07 (95% CI 1.04-1.10) and 3.05 (95% CI 1.71-5.46)] and CKD [with a fully adjusted OR of 1.04 (95% CI 1.02-1.07) and 1.62 (95% CI 1.11-2.35)], respectively. By contrast, neither homocysteine (per 1 μmol/L increase) nor hyperhomocysteinemia were associated with proteinuria in the multivariable logistic regression analysis.


CONCLUSIONS
The study revealed that hyperhomocysteinemia increases the risk of decreased eGFR. This suggests that homocysteine could be considered as a useful molecular markers for delaying the development of CKD.
Department of Nephrology, Qianfoshan Hospital, Shandong University, No. 16766, Jingshi Road, Jinan, 250014, People's Republic of China.
Xianglei
X
Kong
Department of Health Examination Center, Qianfoshan Hospital, Shandong University, No. 16766, Jingshi Road, Jinan, 250014, People's Republic of China.
Xiaojing
X
Ma
Department of Nephrology, Yidu Central Hospital, Weifang Medical College, No. 4138, South Road of Linglong Mountain, Qingzhou, People's Republic of China.
Chengyin
C
Zhang
Department of Nephrology, Qianfoshan Hospital, Shandong University, No. 16766, Jingshi Road, Jinan, 250014, People's Republic of China.
Hong
H
Su
Department of Nephrology, Qianfoshan Hospital, Shandong University, No. 16766, Jingshi Road, Jinan, 250014, People's Republic of China. qianyixdmgmail@163.com.
Dongmei
D
Xu
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002681:China / Q000453:epidemiology; D005260:Female; D005919:Glomerular Filtration Rate; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D020138:Hyperhomocysteinemia / Q000097:blood / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011507:Proteinuria / Q000097:blood / Q000209:etiology; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology; D012307:Risk Factors
D015415:Biomarkers; D006710:Homocysteine
Chronic kidney disease; Epidemilogy; Estimated glomerular filtration rate; Hyperhomocysteinemia; Proteinuria