Abstract
Background: A high level of total plasma homocysteine is a risk factor for atherosclerosis, which is an important cause of death in renal failure. We evaluated the role of this as a risk factor for a vascular complications of end-stage renal disease. Methods and Results: Total fasting plasma homocysteine and other risk factors were documented in 176 dialysis patients (97 men, 79 women; mean age 56.3±14.8 years). Folate, vitamin B 12, and pyridoxal phosphate concentrations were also determined. The prevalence of high total homocysteine values was determined by comparison with a normal reference population, and the risk of associated vascular complications was estimated by multiple logistic regression. Total homocysteine concentration was higher in patients than in the normal population (26.6±1.5 versus 10.1±1.7 μmol/L; P<.01). Abnormally high concentrations (>95th percentile for control subjects, 16.3 μmol/L) were seen in 149 patients (85%) with end- stage renal disease (P<.001). Patients with a homocysteine concentration in the upper two quintiles (>27.8 μmol/L) had an independent odds ratio of 2.9 (CI, 1.4 to 5.8; P=.007) of vascular complications. B vitamin levels were lower in patients with vascular complications than in those without. Vitamin B 6 deficiency was more frequent in patients than in the normal reference population (18% versus 2%; P<.01). Conclusions: A high total plasma homocysteine concentration is an independent risk factor for atherosclerotic complications of end-stage renal disease. Such patients may benefit from higher doses of B vitamins than those currently recommended.
| Original language | English |
|---|---|
| Pages (from-to) | 2743-2748 |
| Number of pages | 6 |
| Journal | Circulation |
| Volume | 94 |
| Issue number | 11 |
| State | Published - Dec 19 1996 |
| Externally published | Yes |
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Keywords
- coronary disease
- kidney
- risk factors
ASJC Scopus subject areas
- Physiology
- Cardiology and Cardiovascular Medicine
Cite this
Hyperhomocysteinemia confers an independent increased risk of atherosclerosis in end-stage renal disease and is closely linked to plasma folate and pyridoxine concentrations. / Robinson, Killian; Gupta, Anjan; Dennis, Vincent; Arheart, Kristopher; Chaudhary, Debashish; Green, Ralph; Vigo, Paul; Mayer, Ellen L.; Selhub, Jacob; Kutner, Michael; Jacobsen, Donald W.
In: Circulation, Vol. 94, No. 11, 19.12.1996, p. 2743-2748.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Hyperhomocysteinemia confers an independent increased risk of atherosclerosis in end-stage renal disease and is closely linked to plasma folate and pyridoxine concentrations
AU - Robinson, Killian
AU - Gupta, Anjan
AU - Dennis, Vincent
AU - Arheart, Kristopher
AU - Chaudhary, Debashish
AU - Green, Ralph
AU - Vigo, Paul
AU - Mayer, Ellen L.
AU - Selhub, Jacob
AU - Kutner, Michael
AU - Jacobsen, Donald W.
PY - 1996/12/19
Y1 - 1996/12/19
N2 - Background: A high level of total plasma homocysteine is a risk factor for atherosclerosis, which is an important cause of death in renal failure. We evaluated the role of this as a risk factor for a vascular complications of end-stage renal disease. Methods and Results: Total fasting plasma homocysteine and other risk factors were documented in 176 dialysis patients (97 men, 79 women; mean age 56.3±14.8 years). Folate, vitamin B 12, and pyridoxal phosphate concentrations were also determined. The prevalence of high total homocysteine values was determined by comparison with a normal reference population, and the risk of associated vascular complications was estimated by multiple logistic regression. Total homocysteine concentration was higher in patients than in the normal population (26.6±1.5 versus 10.1±1.7 μmol/L; P<.01). Abnormally high concentrations (>95th percentile for control subjects, 16.3 μmol/L) were seen in 149 patients (85%) with end- stage renal disease (P<.001). Patients with a homocysteine concentration in the upper two quintiles (>27.8 μmol/L) had an independent odds ratio of 2.9 (CI, 1.4 to 5.8; P=.007) of vascular complications. B vitamin levels were lower in patients with vascular complications than in those without. Vitamin B 6 deficiency was more frequent in patients than in the normal reference population (18% versus 2%; P<.01). Conclusions: A high total plasma homocysteine concentration is an independent risk factor for atherosclerotic complications of end-stage renal disease. Such patients may benefit from higher doses of B vitamins than those currently recommended.
AB - Background: A high level of total plasma homocysteine is a risk factor for atherosclerosis, which is an important cause of death in renal failure. We evaluated the role of this as a risk factor for a vascular complications of end-stage renal disease. Methods and Results: Total fasting plasma homocysteine and other risk factors were documented in 176 dialysis patients (97 men, 79 women; mean age 56.3±14.8 years). Folate, vitamin B 12, and pyridoxal phosphate concentrations were also determined. The prevalence of high total homocysteine values was determined by comparison with a normal reference population, and the risk of associated vascular complications was estimated by multiple logistic regression. Total homocysteine concentration was higher in patients than in the normal population (26.6±1.5 versus 10.1±1.7 μmol/L; P<.01). Abnormally high concentrations (>95th percentile for control subjects, 16.3 μmol/L) were seen in 149 patients (85%) with end- stage renal disease (P<.001). Patients with a homocysteine concentration in the upper two quintiles (>27.8 μmol/L) had an independent odds ratio of 2.9 (CI, 1.4 to 5.8; P=.007) of vascular complications. B vitamin levels were lower in patients with vascular complications than in those without. Vitamin B 6 deficiency was more frequent in patients than in the normal reference population (18% versus 2%; P<.01). Conclusions: A high total plasma homocysteine concentration is an independent risk factor for atherosclerotic complications of end-stage renal disease. Such patients may benefit from higher doses of B vitamins than those currently recommended.
KW - coronary disease
KW - kidney
KW - risk factors
UR - http://www.scopus.com/inward/record.url?scp=10544252271&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=10544252271&partnerID=8YFLogxK
M3 - Article
C2 - 8941098
AN - SCOPUS:10544252271
VL - 94
SP - 2743
EP - 2748
JO - Circulation
JF - Circulation
SN - 0009-7322
IS - 11
ER -