Hyperhomocysteinemia in renal transplantation: preliminary results

Abstract

CARDIOVASCULAR disease (CVD) is a major cause of morbidity and mortality after renal transplantation (RT). The excess risk of CVD in RT is due in part to a higher prevalence of established atherosclerotic risk factors, including hypertension, dyslipidemia, diabetes, obesity, and physical inactivity. However, some renal-related risk factors like immunosuppressive medication and residual renal insufficiency also contribute to this excess CVD risk and may complicate the management of dyslipidemia and hypertension in this population. Accordingly, there is a compelling need to identify and safely manage other putative CVD risk factors among RT patients. Elevated plasma homocysteine is emerging as an important risk factor for cardiovascular disease in general populations. Some studies have demonstrated that hyperhomocysteinemia is present in patients with impaired renal function and is associated with CVD. Only a small number of studies are available on the prevalence and determinants of hyperhomocysteinemia in renal transplant recipients. We undertook this study to 1. estimate the prevalence of hyperhomocysteinemia in renal transplant recipients; 2. examine the relationships between plasma total homocysteine (tHcy) and its metabolic determinants vitamin B6, vitamin B12, and folic acid; and 3. identify other determinants of tHcy.