Plasma Total Homocysteine Concentrations in Patients with Chronic Renal Failure / 대한신장학회잡지

ABSTRACT

Hyperhomocysteinemia, an independent risk factor of vascular disease, is common in patients with chronic renal failure(CRF) patients including dialysis patients. We measured fasting plasma concentrations of total homocysteine(tHcy) by high-performance liquid chromatography in 114 chronic renal patients and 37 healthy controls. The CRF patients were divided into four groups chronic renal failure with serum creatinine >1.4mg/dl and creatinine clearance >10ml/min(CRF group, n=27), non-dialyzed ESRD patients with creatinine clearance <10ml/min(ESRD group, n=38), patients on maintenance hemodialysis(HD group, n=20) and patients on continuous ambulatory peritoneal dialysis(PD group, n=29). Mean(+/-SD) tHcy in each of CRF(14.2+/-5.6micromol/L), ESRD(21.6+/-14.1micromol/L), HD(21.0+/-9.2micromol/L) and PD(17.2+/-7.7micromol/L) group was significantly higher than that in controls(9.0+/-3.1micromol/L, P=0.001). In 87 ESRD, HD and PD patients, mean(SD) tHcy in 45 patients who received routine folate supplementation (1mg/day) was lower(17.5+/-8.3micromol/L) than that in 42 patients without supplementation(22.6+/-13.4micromol/ L, P=0.03), but was higher than that in controls (9.13.1micromol/L, P=0.001). In conclusion, hyperhomocysteinemia was present in patients with varying degree of chronic renal failure and increased in parallel with progression or renal failure.