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만성신부전증 환자에서 혈장 총 Honocysteine 치의 변화 |
김윤구 , 이윤하 , 이규백 , 장세호 , 김대중 , 오하영 |
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Abstract |
Hyperhomocysteinemia, an independent risk factor of vascular disease, is common in patients with chronic renal failure(CRF) patients including dialysis patients. We measured fasting plasma concentrations of total homocysteine(tHcy) by high-performance liquid chromatography in 114 chronic renal patients and 37 healthy controls. The CRF patients were divided into four groups chronic renal failure with serum creatinine >1.4mg/dl and creatinine clearance >10ml/min(CRF group, n=27), nondialyzed ESRD patients with creatinine clearance <10ml/min(ESRD group, n=38), patients on maintenance hemodialysis(HD group, n=20) and patients on continuous ambulatory peritoneal dialysis(PD group, n=29). Mean(± SD) tHcy in each of CRF(14.2±5.6pmol/L), ESRD(21.6± 14.1 p mol/L), HD(21.0±9.2 m mol/L) and PD(17.2±7.7mmol/L) group was significantly higher than that in controls(9.0±3.1 m mol/L, P=0.001). In 87 ESRD, HD and PD patients, mean(SD) tHcy in 45 patients who received routine folate supplementation (1mg/day) was lower(17.5±8.3pmol/L) than that in 42 patients without supplementation(22.6± 13.4 m mol/ L, P=0.03), but was higher than that in controls (9.13.1 m mol/L, P=0.001). In conclusion, hyperhomocysteinemia was present in patients with varying degree of chronic renal failure and increased in parallel with progression or renal failure. |
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