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Elevated homocysteine levels in patients with end-stage renal disease

Ajith P Nair1, Dmitry Nemirovsky, Michael Kim

  • 1Department of Internal Medicine, Mount Sinai School of Medicine, New York, NY, USA.

The Mount Sinai Journal of Medicine, New York
|December 17, 2005
PubMed

Insights

Hemodialysis significantly reduces elevated plasma homocysteine levels in end-stage renal disease (ESRD) patients. However, baseline homocysteine did not predict cardiovascular events, and levels did not change over six months.

Area of Science:

  • Nephrology
  • Cardiology
  • Clinical Chemistry

Background:

  • Elevated plasma homocysteine is a risk factor for cardiovascular disease.
  • Patients with end-stage renal disease (ESRD) often have hyperhomocysteinemia.
  • The impact of hemodialysis on homocysteine levels and its relation to cardiovascular events in ESRD requires further investigation.

Purpose of the Study:

  • To assess the effect of hemodialysis on plasma homocysteine levels in ESRD patients.
  • To determine the relationship between homocysteine levels and clinical cardiovascular events in this population.

Main Methods:

  • A cohort of 147 adult patients undergoing chronic hemodialysis was studied.
  • Plasma homocysteine concentrations were measured pre- and post-dialysis.
  • Clinical cardiovascular events were monitored over a six-month follow-up period.

Main Results:

  • Plasma homocysteine levels were significantly reduced by hemodialysis (p<0.0005).
  • Pre-dialysis homocysteine levels did not differ significantly between patients with and without cardiovascular disease.
  • No significant relationship was found between homocysteine levels and the incidence of ischemic events during follow-up.

Conclusions:

  • Hemodialysis effectively lowers plasma homocysteine in ESRD patients.
  • Elevated homocysteine levels did not predict cardiovascular events in this cohort.
  • Further research is needed to clarify the complex association between homocysteine, hemodialysis, and cardiovascular risk in ESRD.
Abstract

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