Predictive Factors of Cardiovascular Disease in Patients on Maintenance Hemodialysis

Abstract

AbstractOBJECTIVEThe purpose of this study was to identify the role of the methylenetetrahydrofolate reductase (MTHFR) gene mutation and other predictive factors of cardiovascular disease (CVD) in patients on maintenance hemodialysis.METHODSA total of 144 patients with end‐stage renal disease (ESRD) undergoing maintenance hemodialysis for at least 6 months were recruited. The mean age of patients was 44.84 ± 16.23 years. Serum folate, vitamin B12, homocysteine (tHcy), albumin, lipids, MTHFR C677T mutation, and smoking habits were analyzed relative to the presence of CVD.RESULTSForty‐two of the 144 patients (29.1%) had CVD. Mean age, duration of dialysis, body mass index, CRP, Kt/V, male sex, diabetes mellitus, and currently smoking were found to be significantly higher in patients with CVD than in those without CVD (p < 0.05). The means of serum folate, vitamin B12, tHcy, albumin, and percentage of past smokers were not significant (p > 0.05). MTHFR C677T mutation was not found to be associated with CVD risk factors. The mean differences in tHcy levels between the TT and CC and the CT and CC genotype allele groups were significant.CONCLUSIONWe recommend that duration of ESRD and CRP predictors with traditional risk factors be taken into account when examining CVD. We suggest that if patients with ESRD have normal B12 and folate levels, abnormal tHcy level and tHcy metabolism are not risk factors for CVD in patients with ESRD. We do not recommend evaluation of the MTHFR C677T mutation and tHcy level in maintenance hemodialysis patients. The discriminative ability of risk predictors in CVD found in the study present new ideas for researchers studying this subject.