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Association between plasma homocysteine concentrations and cardiac hypertrophy in end-stage renal disease

J Blacher1, K Demuth, A P Guerin

  • 1Department of Internal Medicine, INSERM U 337, Broussais Hospital, APHP, Paris, France.

Journal of Nephrology
|September 24, 1999
PubMed

Insights

High homocysteine levels in end-stage renal disease patients are linked to increased cardiac mass. This finding suggests a significant association between elevated plasma homocysteine and left ventricular hypertrophy risk.

Area of Science:

  • Nephrology
  • Cardiology
  • Biochemistry

Background:

  • End-stage renal disease (ESRD) patients exhibit elevated plasma homocysteine and cardiac mass.
  • Both factors are independent predictors of cardiovascular morbidity and mortality in ESRD.
  • A direct relationship between these parameters requires further investigation.

Purpose of the Study:

  • To investigate the association between plasma homocysteine levels and cardiac mass in ESRD patients undergoing chronic hemodialysis.

Main Methods:

  • Cross-sectional study involving 75 ESRD patients on chronic hemodialysis.
  • Measurement of plasma homocysteine concentrations.
  • Determination of cardiac mass and cardiac mass index.

Main Results:

  • A statistically significant positive association was found between plasma homocysteine and cardiac mass index.
  • This association remained significant after adjusting for age, sex, systolic blood pressure, and hematocrit (p = 0.0027).
  • The adjusted odds ratio for left ventricular hypertrophy was 6.6 for the highest versus lowest homocysteine groups.

Conclusions:

  • This study is the first to demonstrate a statistical link between plasma homocysteine and cardiac structure in ESRD patients, independent of mechanical factors.
  • Elevated plasma homocysteine is associated with an increased adjusted risk of left ventricular hypertrophy in this population.
  • These findings highlight the potential role of homocysteine in cardiac remodeling in ESRD.

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