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Hyperhomocysteinemia and cardiovascular risks in hemodialysis patients

Mohammad Mahdi Sagheb1, Mohammad Ali Ostovan, Zahra Sohrabi

  • 1Shiraz University of Medical Sciences, Shiraz, Iran.

Saudi Journal of Kidney Diseases and Transplantation : an Official Publication of the Saudi Center for Organ Transplantation, Saudi Arabia
|September 4, 2010
PubMed

Insights

In hemodialysis patients, elevated homocysteine levels correlate with cardiac issues like aortic regurgitation and left ventricular abnormalities. This study did not find reverse epidemiology, emphasizing homocysteine as a cardiac risk factor.

Area of Science:

  • Nephrology
  • Cardiology
  • Clinical Biochemistry

Background:

  • Chronic uremic patients face high risks of vascular disease, contributing to over 40% of mortality in dialysis patients.
  • End-stage renal failure (ESRF) patients show significantly elevated plasma homocysteine levels, a known risk factor for cardiovascular death.

Purpose of the Study:

  • To investigate the association between total plasma homocysteine levels and echocardiographic abnormalities in hemodialysis patients.
  • To assess homocysteine as a predictor of cardiac disease outcomes in this population.

Main Methods:

  • A cross-sectional study involving 123 adult maintenance hemodialysis patients who underwent echocardiography.
  • Plasma homocysteine levels were measured and correlated with various echocardiographic parameters and patient demographics.

Main Results:

  • Plasma homocysteine levels showed a direct correlation with the presence of aortic regurgitation (r=0.27, P=0.009).
  • Negative correlations were observed between homocysteine and ejection fraction (r=-0.71, P=0.0001), left ventricular systolic dimension (r=-0.71, P=0.0001), and left ventricular diastolic dimension (r=-0.23, P=0.01).
  • Homocysteine levels were also directly correlated with left ventricular mass index.

Conclusions:

  • The study did not observe reverse epidemiology in the studied hemodialysis patients.
  • Plasma total homocysteine levels are directly associated with cardiac risk factors, including left ventricular mass index and aortic regurgitation, in hemodialysis patients.

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