Relationship between serum homocysteine and other parameters in renal transplant patients

Hyperhomocysteinemia frequently occurs after renal transplantation. We therefore assessed whether serum homocysteine (Hcy) concentrations were correlated with clinical, paraclinical, and arterial Doppler parameters among renal transplant patients.

A cross-sectional study was performed on 47 patients (30 males, 17 females) who received unrelated living donor renal transplants.

The mean serum Hcy concentration was 21.7 +/- 8.4 micromol/L (range = 5.8-48 micromol/L); 37 patients (79%) showed hyperhomocysteinemia (Hcy >or= 15 micromol/L). Serum Hcy was strongly related to body mass index (BMI; r = .43, P = .002), cyclosporine trough level (r = .44, P = .005), and serum creatinine concentration (r = .32, P = .028), but not to age, transplant duration, or sex. Multivariate analysis showed that only BMI (P = .003) and cyclosporine trough level (P = .0037) were independent predictors of serum Hcy concentrations. Hyperhomocysteinemia was more prevalent among patients taking mycophenolate mofetil (MMF) than azathioprine (86% vs 50%; P = 0.017). The hyperhomocysteinemia and normohomocysteinemia groups did not differ significantly in mean carotid intima-media thickness (IMT; 0.78 +/- 0.348 vs 0.77 +/- 0.419 mm, P = .97) or mean intrarenal resistive index (RI) (0.7 +/- 0.06 vs 0.7 +/- 0.06, P = .85). The two groups also did not differ in sex prevalence, diabetes, C-reactive protein >or= 5 mg/L, or mean low-density lipoprotein, high-density lipoprotein, and mean arterial pressure (MAP) values.

Serum Hcy correlated with higher cyclosporine trough levels and obesity. Hyperhomocysteinemia was more common among patients taking MMF than azathioprine, but had no effect on intrarenal RI or carotid IMT.