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[Hyperhomocysteinemia and progression of renal disease]

P Finocchiaro1, C Zoccali

  • 1UO di Nefrologia, Dialisi e Trapianto di Rene, Azienda Ospedaliera Bianchi-Melacrino-Morelli, Reggio Calabria, Italy.

Giornale Italiano Di Nefrologia : Organo Ufficiale Della Societa Italiana Di Nefrologia
|December 13, 2005
PubMed

Insights

High homocysteine levels, a known cardiovascular risk, also predict kidney disease progression. This amino acid damages kidneys, increasing proteinuria and the risk of renal failure.

Area of Science:

  • Nephrology
  • Cardiovascular Medicine
  • Biochemistry

Context:

  • While hyperhomocysteinemia's link to cardiovascular damage is established, its role in renal disease progression remains under-investigated.
  • Experimental data indicate that elevated homocysteine levels cause glomerular and interstitial renal damage, proportional to serum concentrations.

Purpose:

  • To investigate the impact of hyperhomocysteinemia on renal disease progression in human populations.
  • To confirm observational findings on plasma homocysteine as a predictor of kidney damage.

Summary:

  • Prospective and cohort studies demonstrate plasma homocysteine as a significant predictor of proteinuria and renal failure onset in diverse populations.
  • A key proposed mechanism involves homocysteine-induced NO-dependent endothelial dysfunction, linked to reduced dimethylarginine dimethylaminohydrolase activity.

Impact:

  • Establishes hyperhomocysteinemia as a critical, underappreciated factor in renal disease pathogenesis and progression.
  • Highlights the potential for targeting homocysteine levels to mitigate cardiovascular and renal damage.

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