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Titolo:
The kidney and homocysteine metabolism
Autore:
Friedman, AN; Bostom, AG; Selhub, J; Levey, AS; Rosenberg, IH;
Indirizzi:
Tufts Univ, USDA, Human Nutr Res Ctr Aging, Boston, MA 02111 USA Tufts Univ Boston MA USA 02111 n Nutr Res Ctr Aging, Boston, MA 02111 USA Tufts Univ, New England Med Ctr, Div Nephrol, Boston, MA 02111 USA Tufts Univ Boston MA USA 02111 Med Ctr, Div Nephrol, Boston, MA 02111 USA Mem Hosp Rhode Isl, Div Gen Internal Med, Pawtucket, RI 02860 USA Mem HospRhode Isl Pawtucket RI USA 02860 al Med, Pawtucket, RI 02860 USA
Titolo Testata:
JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY
fascicolo: 10, volume: 12, anno: 2001,
pagine: 2181 - 2189
SICI:
1046-6673(200110)12:10<2181:TKAHM>2.0.ZU;2-5
Fonte:
ISI
Lingua:
ENG
Soggetto:
PLASMA TOTAL HOMOCYSTEINE; RENAL-TRANSPLANT RECIPIENTS; PROTEIN-BOUND HOMOCYSTEINE; GLOMERULAR-FILTRATION RATE; NORMAL SERUM CREATININE; HEMODIALYSIS-PATIENTS; N-ACETYLCYSTEINE; AMINO-ACIDS; FOLIC-ACID; METHYLENETETRAHYDROFOLATE REDUCTASE;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
74
Recensione:
Indirizzi per estratti:
Indirizzo: Friedman, AN Tufts Univ, USDA, Human Nutr Res Ctr Aging, 711 Washington St,Room 829, Boston, MA 02111 USA Tufts Univ 711 Washington St,Room 829 Boston MA USA 02111 USA
Citazione:
A.N. Friedman et al., "The kidney and homocysteine metabolism", J AM S NEPH, 12(10), 2001, pp. 2181-2189

Abstract

Homocysteine (Hcy) is an intermediate of methionine metabolism that, at elevated levels, is an independent risk factor for vascular disease and atherothrombosis. Patients with renal disease, who exhibit unusually high rates of cardiovascular morbidity and death, tend to be hyperhomocysteinemic, particularly as renal function declines. This observation and the inverse relationship between Hcy levels and GFR implicate the kidney as an important participant in Hcy handling. The normal kidney plays a major role in plasma amino acid clearance and metabolism. The existence in the kidney of specificHcy uptake mechanisms and Hcy-metabolizing enzymes suggests that this roleextends to Hcy. Dietary protein intake may affect renal Hcy handling and should be considered when measuring Hcy plasma flux and renal clearance. Theunderlying cause of hyperhomocysteinemia in renal disease is not entirely understood but seems to involve reduced clearance of plasma Hcy. This reduction may be attributable to defective renal clearance and/or extrarenal clearance and metabolism, the latter possibly resulting from retained uremic inhibitory substances. Although the currently available evidence is not conclusive, it seems more likely that a reduction in renal Hcy clearance and metabolism is the cause of the hyperhomocysteinemic state. Efforts to resolvethis important issue will advance the search for effective Hcy-lowering therapies in patients with renal disease.

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Documento generato il 12/07/20 alle ore 09:11:09