Homocysteine level in renal transplant recipients and its correlation to glomerular filtration rate, cyclosporine level and folate level

ABSTRACT

Cardiovascular disease [CVD] is the most common cause of death after renal transplantation [RT]. Hyperhomocysteinemia is identified as a risk factor for CVD. RT recipients [RTRs] have an excess prevalence of hyperhomocysteinemia. The objectives of this study were to determine homocysteine [tHCY] level in stable RTRs and correlate its level to graft function, cyslosporine level and folate level. Twenty RTRs of 1[st] living renal allografts, 16 males and 4 females with a mean age of 44.1 +/- 5.1 years and a transplant duration of 22.2 +/- 12.6 months were included in this study. Their mean serum creatinine, blood urea and GFR were 1.5 +/- 0.6 mg/dL, 63 +/- 27.7 mg/dL and 53.9 +/- 32.8 ml/ min respectively. Hyperhomocysteinemia was recorded in all RTRs, mild in 13 [65%] and moderate in 7 [35%] with a mean of 27.9 +/- 12.8 umol/L. Plasma folate level was low [4.5 +/- 5.5 ng/mL]. A significant positive correlation was recorded between tHCY level and both blood urea and serum creatinine [r 0.529, 0.279 respectively, P < 0.05]. There was a significant negative correlation between tHCY level and both GFR and plasma folate level [r - 0.375, - 0.416 respectively, P < 0.05]. No correlation between tHCY level and both duration of renal transplantation and cyclosporine level was recorded. In conclusion, inadequate folate level and or failure to restore normal renal function may be relevant to hyperhomocysteinemia observed in RTRs. tHCY level lowering can be achieved safely, rapidly and in-expensively with B-vitamin intervention