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Plasma reduced homocysteine and other aminothiol concentrations in patients with CKD.
Am J Kidney Dis 2006; 47(1):60-71AJ

Abstract

BACKGROUND

Hyperhomocysteinemia, a risk factor for cardiovascular disease, is present in the majority of patients with chronic kidney disease (CKD). Several studies indicated that the moiety of homocysteine (Hcy) with an unbound -SH group (reduced Hcy [rHcy]) is the atherogenic molecule. This study is designed to examine the relation between different forms of Hcy and other aminothiols in hemodialysis (HD) patients, peritoneal dialysis (PD) patients, and nondialyzed patients with CKD.

METHODS

rHcy, free Hcy (fHcy), and total Hcy (tHcy), as well as different forms of cysteine, cysteinyl-glycine, and glutathione, were studied by using a high-performance liquid chromatography technique in 19 HD patients, 12 PD patients, 47 patients with CKD, and 15 control subjects.

RESULTS

In PD patients, tHcy levels were 2.8 times greater compared with controls, and in HD patients and those with CKD, 2.1 and 1.9 times greater, respectively. Mean rHcy/tHcy ratios were significantly greater in both HD (P < 0.05) and PD patients (P < 0.01), but did not differ in patients with CKD compared with controls. The decrease in rHcy levels during 1 HD treatment was smaller than that in tHcy and fHcy levels, and rHcy/tHcy ratio increased (before HD, 1.25% +/- 0.44%; after HD, 1.44% +/- 0.66%; P < 0.05).

CONCLUSION

Levels of rHcy and other aminothiols are markedly increased in patients with impaired renal function. In dialysis patients, rHcy/tHcy ratio is markedly elevated and shows greater variability than in patients with CKD and controls. We conclude that because rHcy is believed to induce endothelial dysfunction and may be part of the accelerated atherogenic process in patients with CKD, plasma rHcy level could be a more relevant marker of cardiovascular disease risk than tHcy level.

Authors+Show Affiliations

Division of Renal Medicine, Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16377386

Citation

Sjöberg, Bodil, et al. "Plasma Reduced Homocysteine and Other Aminothiol Concentrations in Patients With CKD." American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, vol. 47, no. 1, 2006, pp. 60-71.
Sjöberg B, Anderstam B, Suliman M, et al. Plasma reduced homocysteine and other aminothiol concentrations in patients with CKD. Am J Kidney Dis. 2006;47(1):60-71.
Sjöberg, B., Anderstam, B., Suliman, M., & Alvestrand, A. (2006). Plasma reduced homocysteine and other aminothiol concentrations in patients with CKD. American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, 47(1), pp. 60-71.
Sjöberg B, et al. Plasma Reduced Homocysteine and Other Aminothiol Concentrations in Patients With CKD. Am J Kidney Dis. 2006;47(1):60-71. PubMed PMID: 16377386.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Plasma reduced homocysteine and other aminothiol concentrations in patients with CKD. AU - Sjöberg,Bodil, AU - Anderstam,Björn, AU - Suliman,Mohamed, AU - Alvestrand,Anders, PY - 2005/05/24/received PY - 2005/09/20/accepted PY - 2005/12/27/pubmed PY - 2006/2/10/medline PY - 2005/12/27/entrez SP - 60 EP - 71 JF - American journal of kidney diseases : the official journal of the National Kidney Foundation JO - Am. J. Kidney Dis. VL - 47 IS - 1 N2 - BACKGROUND: Hyperhomocysteinemia, a risk factor for cardiovascular disease, is present in the majority of patients with chronic kidney disease (CKD). Several studies indicated that the moiety of homocysteine (Hcy) with an unbound -SH group (reduced Hcy [rHcy]) is the atherogenic molecule. This study is designed to examine the relation between different forms of Hcy and other aminothiols in hemodialysis (HD) patients, peritoneal dialysis (PD) patients, and nondialyzed patients with CKD. METHODS: rHcy, free Hcy (fHcy), and total Hcy (tHcy), as well as different forms of cysteine, cysteinyl-glycine, and glutathione, were studied by using a high-performance liquid chromatography technique in 19 HD patients, 12 PD patients, 47 patients with CKD, and 15 control subjects. RESULTS: In PD patients, tHcy levels were 2.8 times greater compared with controls, and in HD patients and those with CKD, 2.1 and 1.9 times greater, respectively. Mean rHcy/tHcy ratios were significantly greater in both HD (P < 0.05) and PD patients (P < 0.01), but did not differ in patients with CKD compared with controls. The decrease in rHcy levels during 1 HD treatment was smaller than that in tHcy and fHcy levels, and rHcy/tHcy ratio increased (before HD, 1.25% +/- 0.44%; after HD, 1.44% +/- 0.66%; P < 0.05). CONCLUSION: Levels of rHcy and other aminothiols are markedly increased in patients with impaired renal function. In dialysis patients, rHcy/tHcy ratio is markedly elevated and shows greater variability than in patients with CKD and controls. We conclude that because rHcy is believed to induce endothelial dysfunction and may be part of the accelerated atherogenic process in patients with CKD, plasma rHcy level could be a more relevant marker of cardiovascular disease risk than tHcy level. SN - 1523-6838 UR - https://www.unboundmedicine.com/medline/citation/16377386/Plasma_reduced_homocysteine_and_other_aminothiol_concentrations_in_patients_with_CKD_ DB - PRIME DP - Unbound Medicine ER -