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Hyperhomocysteinemia predicts renal function decline: a prospective study in hypertensive adults

Di Xie1, Yan Yuan1, Jiangnan Guo1

  • 1National Clinical Research Center of Kidney Disease, State Key Laboratory of Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China.

Scientific Reports
|November 11, 2015
PubMed

Insights

Elevated homocysteine levels predict kidney function decline in hypertensive adults. This finding highlights homocysteine as a key biomarker for identifying individuals at risk of developing chronic kidney disease (CKD).

Area of Science:

  • Nephrology
  • Cardiovascular Medicine
  • Clinical Biochemistry

Background:

  • Hyper-homocysteinemia (HHcy) is linked to kidney damage in general and diabetic populations.
  • The association between HHcy and kidney function in hypertensive individuals remains understudied.

Purpose of the Study:

  • To determine if HHcy is an independent risk factor for renal function decline.
  • To investigate the role of HHcy in the development of chronic kidney disease (CKD) among hypertensive adults.

Main Methods:

  • A community-based prospective cohort study involving 2,387 hypertensive adults without CKD at baseline.
  • Follow-up averaged 4.4 years, with measurements of plasma homocysteine (Hcy), folate, vitamin B12, blood pressure, and other covariates.
  • CKD defined by estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m² or eGFR decline rate >1 ml/min/1.73 m²/year.

Main Results:

  • A graded association was observed between homocysteine tertiles and eGFR decline.
  • Individuals in the highest Hcy tertile showed accelerated eGFR decline and increased risk of incident CKD compared to the lowest tertile.
  • These associations persisted after adjusting for multiple confounding factors including age, gender, diabetes, blood pressure, BMI, smoking, dyslipidemia, and vitamin levels.

Conclusions:

  • Elevated baseline plasma homocysteine is an independent biomarker for predicting renal function decline in hypertensive adults.
  • HHcy is a significant risk factor for the development of incident CKD in this population.
  • Findings suggest potential therapeutic targets for preventing kidney disease progression in hypertensive patients.

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