Hyperhomocysteinemia and the risk of cardiovascular disease in hemodialysis patients and renal transplant receipients

ABSTRACT

The aim of this work was to study serum total homocysteine [tHcy] in dialysis dependent end stage renal disease [ESRD] patients as well as in renal transplant recipients [RTR] in relation to the established cardiovascular disease [CVD] risk factors. The study included 20 ESRD patients on hemodialysis [HD, group I], 20 RTR [group II] as well as 15 healthy age and sex matched controls. In HD patients, the mean fasting tHcy was significantly higher than that of the controls and hyperhomocysteinemia occurred in 90% of the patients. In RTR, mean tHcy level was significantly lower than in HD patients, yet still significantly higher than the controls and hyperhomocysteinemia occurred in 60% of the patients. None of the studied CVD risk factors [blood lipids, smoking, and hypertension] was significantly correlated to tHcy. In RTR, tHcy was not correlated to blood cyclosporine trough level. It was concluded that hyperhomocysteinemia was a common characteristic of HD patients and a frequent finding in RTR. The results indicated that hyperhomocysteinemia was associated with the occurrence of cardiovascular disease in both patient groups as an independent risk factor