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Elevated homocysteine and the risk of contrast-induced nephropathy: a cohort study

Lucia Barbieri1, Monica Verdoia1, Alon Schaffer1

  • 1Division of Cardiology, Azienda Ospedaliera-Universitaria "Maggiore della Carità," Eastern Piedmont University, Novara, Italy.

Angiology
|May 17, 2014
PubMed

Insights

Elevated homocysteine levels increase the risk of contrast-induced nephropathy (CIN) in patients with reduced kidney function undergoing cardiac procedures. This finding highlights a potential biomarker for predicting CIN risk.

Area of Science:

  • Nephrology
  • Cardiology
  • Biochemistry

Background:

  • Contrast-induced nephropathy (CIN) is a significant complication for patients with impaired kidney function undergoing cardiovascular procedures.
  • Elevated homocysteine is linked to oxidative stress and may contribute to kidney damage.

Purpose of the Study:

  • To investigate the association between homocysteine levels and the incidence of CIN in patients with creatinine clearance <60 mL/min.
  • To determine if homocysteine serves as a predictive biomarker for CIN risk.

Main Methods:

  • A cohort of 876 patients with reduced kidney function undergoing coronary angiography/PCI were stratified into tertiles based on homocysteine levels.
  • CIN was defined by creatinine increase (≥0.5 mg/dL or ≥25%) within 48 hours post-procedure.
  • Statistical analysis, including adjusted odds ratios, was used to assess the relationship between homocysteine and CIN.

Main Results:

  • A significant positive association was found between higher homocysteine levels and increased CIN risk (adjusted OR = 1.68, P = .019).
  • The association remained significant using a newer definition of contrast-induced acute kidney injury (adjusted OR = 1.96, P = .001).
  • Incidence of CIN increased progressively across homocysteine tertiles (11.9%, 10.4%, 22.8%).

Conclusions:

  • Elevated homocysteine levels are significantly associated with an increased risk of contrast-induced nephropathy in patients with pre-existing kidney dysfunction.
  • Homocysteine may represent a valuable biomarker for identifying patients at higher risk for CIN.
  • Further research is warranted to confirm these findings and explore therapeutic interventions targeting homocysteine.

Keywords:
contrast-induced nephropathycreatininehomocysteinekidney functionpercutaneous coronary intervention

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