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Titolo:
Relationships between homocysteine and related amino acids in chronic hemodialysis patients
Autore:
McDonald, SP; Whiting, MJ; Tallis, GA; Barbara, JAJ;
Indirizzi:
Menzies Sch Hlth Res, Casuarina, NT 0811, Australia Menzies Sch Hlth Res Casuarina NT Australia 0811 rina, NT 0811, Australia Flinders Med Ctr, Dept Biochem, Adelaide, SA, Australia Flinders Med Ctr Adelaide SA Australia Biochem, Adelaide, SA, Australia Flinders Med Ctr, Dept Med, Adelaide, SA, Australia Flinders Med Ctr Adelaide SA Australia Dept Med, Adelaide, SA, Australia
Titolo Testata:
CLINICAL NEPHROLOGY
fascicolo: 6, volume: 55, anno: 2001,
pagine: 465 - 470
SICI:
0301-0430(200106)55:6<465:RBHARA>2.0.ZU;2-M
Fonte:
ISI
Lingua:
ENG
Soggetto:
STAGE RENAL-DISEASE; CARDIOVASCULAR RISK FACTOR; PLASMA HOMOCYSTEINE; FOLIC-ACID; ENDOTHELIAL DYSFUNCTION; DIALYSIS PATIENTS; RAT-KIDNEY; HYPERHOMOCYSTEINEMIA; SUPPLEMENTATION; PYRIDOXINE;
Keywords:
homocysteine; serine; glycine; methionine; folate;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
35
Recensione:
Indirizzi per estratti:
Indirizzo: McDonald, SP Menzies Sch Hlth Res, POB 41096, Casuarina, NT 0811, Australia Menzies Sch Hlth Res POB 41096 Casuarina NT Australia 0811 ia
Citazione:
S.P. McDonald et al., "Relationships between homocysteine and related amino acids in chronic hemodialysis patients", CLIN NEPHR, 55(6), 2001, pp. 465-470

Abstract

Aims: Homocysteine (Hey) has emerged as an important risk factor for atherosclerotic disease. Elevated levels in chronic dialysis patients may contribute to high vascular mortality, but little is known about levels of related amino acids in this group. In an observational study in the clinical setting we sought to document these. Methods: In 114 hemodialysis patients pre-dialysis total plasma homocysteine, vitamin BI, and red blood cell (RBC) folate concentrations were measured. In a subgroup of patients (n = 42), other plasma amino acids were measured pre- and post-dialysis. All patients were routinely taking oral folic acid supplements (1.2 mg per week). Results: Elevated homocysteine concentrations were found in all patients (geometric mean 33.1 umol/l, range 13.8 - 69.2 umol/l, laboratory reference range (RR)3 - 13 umol/l). RBC folate levels were high (1223 +/- 54.5 nmol/l mean +/-SE, RR 300 - 710 nmol/l) and inversely related to pre-dialysis plasma Hey (r = -0.44, p < 0.001). Hey levels were not related to vitamin B-12 levels. A history of vascular disease was not associated with higher concentrations of Hey. Hey clearance on dialysis was substantial (mean Hey reduction 33 /- 14%). While plasma methionine levels were normal, serine levels were significantly lower than the reference range (59.3 2.39 umol/l (mean +/- SE, RR 70 - 195 umol/l)) and directly related to levels of glycine (r = 0.52, p< 0.001). Glycine levels were within normal range. Although overall levelswere low, higher serine levels were related to elevated homocysteine (r = 0.42, p < 0.01). Dialytic loss of glycine, serine and methionine was moderate. Conclusion: An inverse association between RBC folate and homocysteine levels extended to 3 times the upper limit of normal for folate, suggestinga role for high dose folic acid supplementation in the treatment of renal-failure related hyperhomocy-steinemia. Low serine levels are expected as itis primarily synthesized in the kidney. The direct relationship between serine and homocysteine is consistent with the reported lack of effect of serine supplements on high Hey levels.

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Documento generato il 06/04/20 alle ore 09:36:53