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Potential association of hyperhomocysteinemia with the progression of IgA nephropathy: a retrospective study
Shuwei Duan1, Shuwen Liu1, Xuefeng Sun1
1Department of Nephrology, Chinese People's Liberation Army General Hospital (301 Hospital), Chinese People's Liberation Army Institute of Nephrology, State Key Laboratory of Kidney Diseases (2011DAV00088), National Clinical Research Center of Kidney Diseases (2013BAI09B05), Beijing 100853, China.
Insights
High homocysteine (HHcy) levels are linked to arterial lesions and worse progression in IgA nephropathy patients. This finding suggests HHcy may help predict IgA nephropathy outcomes.
Area of Science:
- Nephrology
- Cardiovascular Medicine
- Clinical Research
Background:
- Elevated homocysteine (Hcy) levels in hyperhomocysteinemia (HHcy) are associated with cardiovascular disease risks, particularly in end-stage renal disease (ESRD).
- The role of HHcy in the progression of IgA nephropathy (IgAN) requires further investigation.
Purpose of the Study:
- To investigate the association between HHcy and the progression of IgA nephropathy.
- To determine if HHcy is a risk factor for intrarenal arterial lesions and end-stage renal disease in IgAN patients.
Main Methods:
- A cohort of 108 patients newly diagnosed with IgA nephropathy was analyzed.
- Logistic regression was used to assess the association between clinicopathological factors and Hcy levels.
- Cox regression was employed to analyze the risk of ESRD.
Main Results:
- 12.04% of patients had HHcy. HHcy was significantly associated with intrarenal arterial lesions (OR 2.60; P < 0.001) after adjusting for covariates.
- Patients with HHcy showed a significantly higher risk of progressing to ESRD (HR 4.71; P = 0.010) during a mean follow-up of 67.37 months.
Conclusions:
- HHcy is an independent risk factor for intrarenal arterial lesions in IgA nephropathy.
- HHcy levels may serve as a prognostic marker for IgA nephropathy progression and ESRD risk.
Background:
The high blood homocysteine (Hcy) levels found in patients with hyperhomocysteinemia (HHcy) have been implicated in an increased risk of cardiovascular disease morbidity and mortality in end-stage renal disease (ESRD). This study investigated the association of HHcy with progression of IgA nephropathy.
Methods:
We analyzed 108 participants newly diagnosed with IgA nephropathy between August 2005 and August 2007 in the Department of Nephrology, Chinese People's Liberation Army General Hospital. The association between clinicopathological factors and the Hcy levels were analyzed by Logistic regression and those with ESRD risk were analyzed by Cox regression.
Results:
Patients were aged (35.71 ± 10.73) years and included 45.71% women and 12.04% patients with HHcy. In multivariate Logistic regression analysis, HHcy was associated with arterial lesions (OR 2.60; 95% CI 1.55 ± 4.34; P < 0.001) even when age, body mass index, estimated glomerular filtration rate, mean arterial pressure, and initial proteinuria were taken into account. Mean follow-up was (67.37 ± 16.21) months. HHcy was also associated with worse ESRD-free survival (HR 4.71; 95% CI 1.45 to 15.31; P = 0.010).
Conclusion:
HHcy is associated with the risk of intrarenal arterial lesions and may be useful for estimating the prognosis of IgA nephropathy.
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