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Plasma homocysteine concentration changes after renal transplantation in children.
Pediatr Nephrol 2002; 17(7):520-3PN

Abstract

Hyperhomocysteinemia, a risk factor for vascular disease, is found in children as well as in 80% of adult patients with end-stage renal disease. The aim of this study was to assess the changes in plasma homocysteine concentrations after renal transplantation (RT). Plasma homocysteine, vitamin B(12), and folate concentrations were prospectively measured in six patients at three points, before and post transplantation (6 months, 4 years), and compared with controls using standardized scores (Z score) for each of these parameters. Folic acid supplementation was introduced after the evaluation at 6 months. Patients had elevated median plasma homocysteine Z scores during dialysis (4.12). When assessed at 6 months and 4 years, median plasma homocysteine Z scores were, respectively, 2.35 and 0.29. Median folate Z scores were 1.89 during dialysis, -0.26 at 6 months, and 3.26 at 4 years post RT. Median vitamin B(12) Z score was 2.12 during dialysis, 0.58 at 6 months, and -0.07 at 4 years post RT. Glomerular filtration rate (GFR) improved after RT, with median GFR of 84.5 ml/min per 1.73 m(2) at 6 months. This stabilized to a value of 70.5 ml/min per 1.73 m(2) at 4 years. When comparing values before and after RT at 6 months, changes were observed only for GFR (P<0.03) and vitamin B(12) (P<0.05). There were no changes in plasma homocysteine, folate, and serum albumin. At 4 years, a significant decrease in plasma homocysteine was observed (P<0.05) with increased GFR (P<0.03). No significant changes were observed in plasma albumin, folate, and vitamin B(12) concentrations. In conclusion, elevated plasma homocysteine in children during dialysis persists after RT despite a significant improvement in renal function. However, normalization was attained when patients were supplemented with folic acid. Further controlled studies are required to evaluate the determinants and treatment of elevated plasma homocysteine in pediatric transplant patients.

Authors+Show Affiliations

Department of Pediatric Nephrology, Ste-Justine Hospital, 3175 Cote Sainte-Catherine, Montréal, Québec, Canada, H3T1C5. merouana@ere.umontreal.caNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

12172766

Citation

Merouani, Aicha, et al. "Plasma Homocysteine Concentration Changes After Renal Transplantation in Children." Pediatric Nephrology (Berlin, Germany), vol. 17, no. 7, 2002, pp. 520-3.
Merouani A, Delvin EE, Genest J, et al. Plasma homocysteine concentration changes after renal transplantation in children. Pediatr Nephrol. 2002;17(7):520-3.
Merouani, A., Delvin, E. E., Genest, J., Rozen, R., & Lambert, M. (2002). Plasma homocysteine concentration changes after renal transplantation in children. Pediatric Nephrology (Berlin, Germany), 17(7), pp. 520-3.
Merouani A, et al. Plasma Homocysteine Concentration Changes After Renal Transplantation in Children. Pediatr Nephrol. 2002;17(7):520-3. PubMed PMID: 12172766.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Plasma homocysteine concentration changes after renal transplantation in children. AU - Merouani,Aicha, AU - Delvin,Edgar E, AU - Genest,Jacques,Jr AU - Rozen,Rima, AU - Lambert,Marie, Y1 - 2002/05/22/ PY - 2001/11/14/received PY - 2002/02/17/revised PY - 2002/02/20/accepted PY - 2002/8/13/pubmed PY - 2003/2/8/medline PY - 2002/8/13/entrez SP - 520 EP - 3 JF - Pediatric nephrology (Berlin, Germany) JO - Pediatr. Nephrol. VL - 17 IS - 7 N2 - Hyperhomocysteinemia, a risk factor for vascular disease, is found in children as well as in 80% of adult patients with end-stage renal disease. The aim of this study was to assess the changes in plasma homocysteine concentrations after renal transplantation (RT). Plasma homocysteine, vitamin B(12), and folate concentrations were prospectively measured in six patients at three points, before and post transplantation (6 months, 4 years), and compared with controls using standardized scores (Z score) for each of these parameters. Folic acid supplementation was introduced after the evaluation at 6 months. Patients had elevated median plasma homocysteine Z scores during dialysis (4.12). When assessed at 6 months and 4 years, median plasma homocysteine Z scores were, respectively, 2.35 and 0.29. Median folate Z scores were 1.89 during dialysis, -0.26 at 6 months, and 3.26 at 4 years post RT. Median vitamin B(12) Z score was 2.12 during dialysis, 0.58 at 6 months, and -0.07 at 4 years post RT. Glomerular filtration rate (GFR) improved after RT, with median GFR of 84.5 ml/min per 1.73 m(2) at 6 months. This stabilized to a value of 70.5 ml/min per 1.73 m(2) at 4 years. When comparing values before and after RT at 6 months, changes were observed only for GFR (P<0.03) and vitamin B(12) (P<0.05). There were no changes in plasma homocysteine, folate, and serum albumin. At 4 years, a significant decrease in plasma homocysteine was observed (P<0.05) with increased GFR (P<0.03). No significant changes were observed in plasma albumin, folate, and vitamin B(12) concentrations. In conclusion, elevated plasma homocysteine in children during dialysis persists after RT despite a significant improvement in renal function. However, normalization was attained when patients were supplemented with folic acid. Further controlled studies are required to evaluate the determinants and treatment of elevated plasma homocysteine in pediatric transplant patients. SN - 0931-041X UR - https://www.unboundmedicine.com/medline/citation/12172766/Plasma_homocysteine_concentration_changes_after_renal_transplantation_in_children_ L2 - https://dx.doi.org/10.1007/s00467-002-0868-4 DB - PRIME DP - Unbound Medicine ER -