2.50
Hdl Handle:
http://hdl.handle.net/2336/47467
Title:
Influence of haemodialysis on plasma total homocysteine concentration
Authors:
Arnadottir, M; Berg, A L; Hegbrant, J; Hultberg, B
Citation:
Nephrol. Dial. Transplant. 1999, 14(1):142-6
Issue Date:
1-Jan-1999
Abstract:
BACKGROUND: The high prevalence of hyperhomocysteinaemia in uraemic patients is of interest because of the cardiovascular risk associated with increased plasma total homocysteine (tHcy) concentration. Treatment with folic acid lowers tHcy in haemodialysis patients, however, in most patients not to normohomocysteinaemic levels. With possible tHcy-lowering modifications in mind, we studied the influence of standard haemodialysis on tHcy. METHODS: In 56 folate-loaded haemodialysis patients, tHcy and parameters of dialysis adequacy were measured. In six patients, interdialytic curves of tHcy and serum creatinine concentrations were obtained and in five patients, the amount of homocysteine (Hcy) in dialysate was determined. RESULTS: tHcy (21.8+/-14.4 micromol/l) correlated significantly with Kt/V (r=0.32, P<0.05), total Kt/V (r=0.29, P<0.05), nPCR (r=0.30, P<0.05) and serum concentrations of albumin (r=0.28, P<0.05) and cobalamines (r=-0.27, P<0.05). In a multiple linear regression analysis, only serum albumin concentrations significantly predicted tHcy (r=0.34, P < 0.05). During dialysis, tHcy decreased by 28% and remained constant for at least 8 h after treatment. The amount of Hcy recovered in dialysate was 63 micromol (12-158 micromol). There was no difference in tHcy between those who had residual renal function and those who had not. CONCLUSIONS: The direct relationship between tHcy and Kt/V seemed to be mediated by the serum albumin concentration. The shape of the interdialytic tHcy curve suggested facilitated Hcy removal for at least 8 h after dialysis possibly due to reduced levels of inhibitory activities against relevant enzyme(s). The dialysed amount of Hcy did not seem to contribute significantly to Hcy removal. Thus, modifications of standard dialytic regimens are not likely to be effective from a tHcy-lowering point of view whereas convective procedures such as haemofiltration or haemodiafiltration might be more effective.
Description:
Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/Open
Additional Links:
http://ndt.oxfordjournals.org/cgi/content/abstract/14/1/142

Full metadata record

DC FieldValue Language
dc.contributor.authorArnadottir, M-
dc.contributor.authorBerg, A L-
dc.contributor.authorHegbrant, J-
dc.contributor.authorHultberg, B-
dc.date.accessioned2009-01-15T11:40:00Z-
dc.date.available2009-01-15T11:40:00Z-
dc.date.issued1999-01-01-
dc.date.submitted2009-01-15-
dc.identifier.citationNephrol. Dial. Transplant. 1999, 14(1):142-6en
dc.identifier.issn0931-0509-
dc.identifier.pmid10052494-
dc.identifier.doi10.1093/ndt/14.1.142-
dc.identifier.urihttp://hdl.handle.net/2336/47467-
dc.descriptionNeðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/Openen
dc.description.abstractBACKGROUND: The high prevalence of hyperhomocysteinaemia in uraemic patients is of interest because of the cardiovascular risk associated with increased plasma total homocysteine (tHcy) concentration. Treatment with folic acid lowers tHcy in haemodialysis patients, however, in most patients not to normohomocysteinaemic levels. With possible tHcy-lowering modifications in mind, we studied the influence of standard haemodialysis on tHcy. METHODS: In 56 folate-loaded haemodialysis patients, tHcy and parameters of dialysis adequacy were measured. In six patients, interdialytic curves of tHcy and serum creatinine concentrations were obtained and in five patients, the amount of homocysteine (Hcy) in dialysate was determined. RESULTS: tHcy (21.8+/-14.4 micromol/l) correlated significantly with Kt/V (r=0.32, P<0.05), total Kt/V (r=0.29, P<0.05), nPCR (r=0.30, P<0.05) and serum concentrations of albumin (r=0.28, P<0.05) and cobalamines (r=-0.27, P<0.05). In a multiple linear regression analysis, only serum albumin concentrations significantly predicted tHcy (r=0.34, P < 0.05). During dialysis, tHcy decreased by 28% and remained constant for at least 8 h after treatment. The amount of Hcy recovered in dialysate was 63 micromol (12-158 micromol). There was no difference in tHcy between those who had residual renal function and those who had not. CONCLUSIONS: The direct relationship between tHcy and Kt/V seemed to be mediated by the serum albumin concentration. The shape of the interdialytic tHcy curve suggested facilitated Hcy removal for at least 8 h after dialysis possibly due to reduced levels of inhibitory activities against relevant enzyme(s). The dialysed amount of Hcy did not seem to contribute significantly to Hcy removal. Thus, modifications of standard dialytic regimens are not likely to be effective from a tHcy-lowering point of view whereas convective procedures such as haemofiltration or haemodiafiltration might be more effective.en
dc.language.isoenen
dc.publisherOxford University Pressen
dc.relation.urlhttp://ndt.oxfordjournals.org/cgi/content/abstract/14/1/142en
dc.subject.meshAgeden
dc.subject.meshFemaleen
dc.subject.meshFolic Aciden
dc.subject.meshHomocysteineen
dc.subject.meshHumansen
dc.subject.meshMaleen
dc.subject.meshRegression Analysisen
dc.subject.meshRenal Dialysisen
dc.subject.meshSerum Albuminen
dc.subject.meshUreaen
dc.titleInfluence of haemodialysis on plasma total homocysteine concentrationen
dc.typeArticleen
dc.contributor.departmentDepartment of Medicine, National University Hospital, Reykjavik, Iceland.en
dc.identifier.journalNephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Associationen

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