Hyperhomocyst(e)inemia in chronic stable renal transplant patients
Rev. Hosp. Clin. Fac. Med. Univ. Säo Paulo
;
55(5): 161-8, Sept. 2000. tab
Artículo
en Inglés
| LILACS
| ID: lil-275168
ABSTRACT
PURPOSE:
Hyperhomocyst(e)inaemia is an important risk factor for atherosclerosis, which is currently a major cause of death in renal transplant patients. The aim of this study was to assess the influence of immunosuppressive therapy on homocyst(e)inemia in renal transplant recipients.METHODS:
Total serum homocysteine (by high performance liquid chromatography), creatinine, lipid profile, folic acid (by radioimmunoassay-RIA) and vitamin B12 (by RIA) concentrations were measured in 3 groups. Group I patients (n=20) were under treatment with cyclosporine, azathioprine, and prednisone; group II (n=9) were under treatment with azathioprine and prednisone; and group III (n=7) were composed of renal graft donors for groups I and II. Creatinine, estimated creatinine clearance, cyclosporine trough level, lipid profile, folic acid, and vitamin B12 concentrations and clinical characteristics of patients were assessed with the aim of ascertaining determinants of hyperhomocyst(e)inemia.RESULTS:
Patient ages were 48.8 ñ 15.1 yr (group I), 43.3 ñ 11.3 yr (group II); and 46.5 ñ 14.8 yr (group III). Mean serum homocyst(e)ine (tHcy) concentrations were 18.07 ñ 8.29 mmol/l in renal transplant recipients; 16.55 ñ 5.6 mmol/l and 21.44 ñ 12.1 mmol/l respectively for group I (with cyclosporine) and group II (without cyclosporine) (NS). In renal donors, tHcy was significantly lower (9.07 ñ 3.06 mmol/l; group I + group II vs. group III, p<0.008). There was an unadjusted correlation (p<0.10) between age (r=0.427; p<0.005) body weight (r=0.412; p<0.05), serum creatinine (r=0.427; p<0.05), estimated creatinine clearance (r=0.316; p<0.10), and tHcy in renal recipients (group I +II). Independent regressors (r2=0.46) identified in the multiple regression model were age (coefficient= 0.253; p=0.009) and serum creatinine (coefficient=8.07; p=0.045). We found no cases of hyperhomocyst(e)inemia in the control group. In contrast, 38 per cent of renal recipients had hyperhomocyst(e)inemia 7 cases (35 per cent) on cyclosporine and 4 (45 per cent) without cyclosporine, based on serum normal levels.CONCLUSIONS:
Renal transplant recipients frequently have hyperhomocyst(e)inemia. Hyperhomocyst(e)inemia in renal transplant patients is independent of the scheme of immunosuppression they are taking. The older the patients are and the higher are their serum creatinine levels, the more susceptible they are to hyperhomocyst(e)inemia following renal transplantation
Texto completo:
Disponible
Índice:
LILACS (Américas)
Asunto principal:
Trasplante de Riñón
/
Hiperhomocisteinemia
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Creatinina
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Homocisteína
/
Inmunosupresores
Tipo de estudio:
Estudio observacional
/
Estudio de prevalencia
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Estudio pronóstico
/
Factores de riesgo
Límite:
Humanos
Idioma:
Inglés
Revista:
Rev. Hosp. Clin. Fac. Med. Univ. Säo Paulo
Asunto de la revista:
Medicina
Año:
2000
Tipo del documento:
Artículo
País de afiliación:
Brasil
Institución/País de afiliación:
Universidade de Säo Paulo/BR
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