Korean Journal of Nephrology 2000;19(6):1106-1114.

만성 신부전 환자에서 과호모시스테인혈증의 유병율 및 그 결정 인자 (Prevalence and Determinants of Hyperhomocysteinemia in Patients with Chronic Renal Failure)

최원(Won Choi) , 김정기(Jung Gee Kim) , 박미정(Mi Jung Park) , 박병석(Byung Suk Park) , 나명윤(Myung Yoon Na) , 염충호(Choong Ho Yeom) , 김수완(Soo Wan Kim) , 최기철(Gee Chul Choi) , 강영준

Abstract

Background
Hyperhomocysteinemia plays an important role in atherosclerosis resulting from endothelial dysfunction and injury followed by platelet activation and thrombus formation. We evaluated the prevalence and determinants of hyperhomocysteinemia in patients with chronic renal failure(CRF) and relationship between hyperhomocysteinemia and cardiovascular diseases. Methods: We evaluated the prevalence of hyperhomocysteinemia in CRF patients and hemodialysis patients. Fasting plasma homocysteine, vitamin B12, vitamin B6 creatinine, fibrinogen, lipoprotein(a), glucose, total cholesterol, HDL cholesterol, and TG levels were assessed in 69 patients. Results: Hyperhomocysteinemia was detected 5% in controls, 86% in CRF groups, and 85% in hemodialysis group. Serum folate value in hemodialysis group was significantly higher than normal control (10.7±4.8 vs. 15.3±5.4nmoL/L; p<0.05). Plasma homocysteine concentration negatively correlated with serum folate level in hemodialysis patients(r=-0.42, p<0.05). Cardiovascular diseases were deteceted 14% in CRF patients and 25% in hemodialysis patients. Matched odds ratios(with 95% confidence intervals) were respectively 118.75, 107.7 for homocysteine in CRF and hemodialysis patients compaired with control group. Conclusion: Plasma homocysteine level correlated negatively with serum folate level in hemodialysis patients. In univariate analysis, determinant of plasma homocysteine concentration in hemodialysis patients is plasma folate concentration. We considered that hyperhornocysteinemia is also an independent risk factor of cardiovascular diseases.