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Hyperhomocysteinemia and the risk of thromboembolic phenomenon in patients with chronic renal failure

Majdi M Abdel-Raheem1, Brian Hebert, Anil Potti

  • 1Department of Medicine, University of North Dakota School of Medicine, Fargo, ND 58102, USA.

Thrombosis Research
|May 29, 2002
PubMed

Insights

Hyperhomocysteinemia (HHe) significantly increases the risk of cerebrovascular accidents (CVA) in patients with chronic renal failure (CRF). This study found elevated homocysteine levels to be an independent predictor of CVA in this population.

Area of Science:

  • Nephrology
  • Cardiovascular Medicine
  • Neurology

Background:

  • Thromboembolic events are a significant cause of illness and death in end-stage renal disease patients.
  • Hyperhomocysteinemia (HHe) is linked to increased coronary artery disease (CAD) risk in chronic renal failure (CRF) patients.
  • Limited data exist on the HHe-cerebrovascular disease (CVA) link in CRF.

Purpose of the Study:

  • To investigate the effect of HHe on CVA and CAD incidence in patients with CRF.
  • To determine if elevated homocysteine levels are an independent predictor of CVA or CAD in CRF.

Main Methods:

  • Observational retrospective study involving 110 male CRF patients (creatinine clearance <50 ml/min).
  • Defined HHe as fasting plasma homocysteine (HC) >15 micromol/l.
  • Analyzed HC levels in relation to CVA and CAD, adjusting for confounders.

Main Results:

  • Elevated HC levels (>15 micromol/l) were an independent predictor of CVA (OR 10.9, p=.01).
  • A strong relationship was observed between HHe and CVA.
  • No significant association was found between HHe and CAD in this cohort.

Conclusions:

  • Hyperhomocysteinemia is a significant independent risk factor for cerebrovascular accidents in patients with chronic renal failure.
  • Further large-scale prospective trials are needed to confirm the impact of HHe on CVA and CAD in CRF.
  • The findings highlight the importance of monitoring homocysteine levels in CRF patients to mitigate cerebrovascular risks.

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