5.00
Hdl Handle:
http://hdl.handle.net/2336/47993
Title:
Serum total homocysteine concentration before and after renal transplantation
Authors:
Arnadottir, M; Hultberg, B; Wahlberg, J; Fellström, B; Dimény, E
Citation:
Kidney Int. 1998, 54(4):1380-4
Issue Date:
1-Oct-1998
Abstract:
BACKGROUND: Hyperhomocysteinemia is by now an established risk factor for the development of atherosclerosis. Total homocysteine concentration (tHcy) correlates inversely with glomerular filtration rate, and it is roughly three times as high in hemodialysis patients as in healthy individuals. Therefore, tHcy would be expected to fall markedly after successful renal transplantation. The aim of the present study was to assess the changes in tHcy associated with renal transplantation. METHODS: tHcy was analyzed in samples collected before renal transplantation and at six months after transplantation in 55 stable patients, all of whom were treated with cyclosporine (CS). tHcy was also analyzed in samples from 55 controls characterized by markers of renal function that matched those of the post-transplant state. RESULTS: At six months after transplantation, tHcy was significantly decreased as compared with pretransplant tHcy (27.7 +/- 14.8 vs. 36.9 +/- 21.3 micromol/liter, P < 0.001). Post-transplant tHcy was markedly higher than the tHcy of the control group (27.7 +/- 14.8 vs. 16.0 +/- 5.3 micromol/liter, P < 0.0001). The post-transplant change in tHcy ranged widely, the average change being a reduction of 14%. Sixteen patients (29%) actually manifested an increase in post-transplant tHcy. The post-transplant changes in tHcy correlated inversely with pretransplant tHcy (r = -0.66, P < 0.0001) and directly with the changes in serum albumin concentrations (r = 0.35, P < 0.05) and CS trough concentrations (r = 0.29, P < 0.05). A multivariate analysis, including the post-transplant changes in serum concentrations of folate and albumin as well as creatinine clearances explained 21% of the change in tHcy (P < 0.05). After inclusion of the CS concentration, an independent predictor, the model accounted for 28% of the post-transplant change in tHcy (P < 0.01). CONCLUSION: The post-transplant reduction in tHcy was far smaller than expected with respect to renal function, and the post-transplant changes in the major biochemical determinants of tHcy contributed relatively little to explain the change in tHcy. Thus, the results suggest the post-transplant introduction of one or more factors that induce an increase in tHcy. Treatment with CS appears to be such a factor.
Description:
To access publisher full text version of this article. Please click on the hyperlink in Additional Links field
Additional Links:
http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=5881765&site=ehost-live

Full metadata record

DC FieldValue Language
dc.contributor.authorArnadottir, M-
dc.contributor.authorHultberg, B-
dc.contributor.authorWahlberg, J-
dc.contributor.authorFellström, B-
dc.contributor.authorDimény, E-
dc.date.accessioned2009-01-26T09:45:37Z-
dc.date.available2009-01-26T09:45:37Z-
dc.date.issued1998-10-01-
dc.date.submitted2009-01-26-
dc.identifier.citationKidney Int. 1998, 54(4):1380-4en
dc.identifier.issn0085-2538-
dc.identifier.pmid9767559-
dc.identifier.doi10.1046/j.1523-1755.1998.00112.x-
dc.identifier.urihttp://hdl.handle.net/2336/47993-
dc.descriptionTo access publisher full text version of this article. Please click on the hyperlink in Additional Links fielden
dc.description.abstractBACKGROUND: Hyperhomocysteinemia is by now an established risk factor for the development of atherosclerosis. Total homocysteine concentration (tHcy) correlates inversely with glomerular filtration rate, and it is roughly three times as high in hemodialysis patients as in healthy individuals. Therefore, tHcy would be expected to fall markedly after successful renal transplantation. The aim of the present study was to assess the changes in tHcy associated with renal transplantation. METHODS: tHcy was analyzed in samples collected before renal transplantation and at six months after transplantation in 55 stable patients, all of whom were treated with cyclosporine (CS). tHcy was also analyzed in samples from 55 controls characterized by markers of renal function that matched those of the post-transplant state. RESULTS: At six months after transplantation, tHcy was significantly decreased as compared with pretransplant tHcy (27.7 +/- 14.8 vs. 36.9 +/- 21.3 micromol/liter, P < 0.001). Post-transplant tHcy was markedly higher than the tHcy of the control group (27.7 +/- 14.8 vs. 16.0 +/- 5.3 micromol/liter, P < 0.0001). The post-transplant change in tHcy ranged widely, the average change being a reduction of 14%. Sixteen patients (29%) actually manifested an increase in post-transplant tHcy. The post-transplant changes in tHcy correlated inversely with pretransplant tHcy (r = -0.66, P < 0.0001) and directly with the changes in serum albumin concentrations (r = 0.35, P < 0.05) and CS trough concentrations (r = 0.29, P < 0.05). A multivariate analysis, including the post-transplant changes in serum concentrations of folate and albumin as well as creatinine clearances explained 21% of the change in tHcy (P < 0.05). After inclusion of the CS concentration, an independent predictor, the model accounted for 28% of the post-transplant change in tHcy (P < 0.01). CONCLUSION: The post-transplant reduction in tHcy was far smaller than expected with respect to renal function, and the post-transplant changes in the major biochemical determinants of tHcy contributed relatively little to explain the change in tHcy. Thus, the results suggest the post-transplant introduction of one or more factors that induce an increase in tHcy. Treatment with CS appears to be such a factor.en
dc.language.isoenen
dc.publisherNature Publishing Groupen
dc.relation.urlhttp://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=5881765&site=ehost-liveen
dc.subject.meshAdulten
dc.subject.meshAgeden
dc.subject.meshArteriosclerosisen
dc.subject.meshCase-Control Studiesen
dc.subject.meshCyclosporineen
dc.subject.meshFemaleen
dc.subject.meshGlomerular Filtration Rateen
dc.subject.meshHomocysteineen
dc.subject.meshHumansen
dc.subject.meshImmunosuppressive Agentsen
dc.subject.meshKidney Failure, Chronicen
dc.subject.meshKidney Transplantationen
dc.subject.meshMaleen
dc.subject.meshMiddle Ageden
dc.subject.meshRisk Factorsen
dc.subject.meshTime Factorsen
dc.titleSerum total homocysteine concentration before and after renal transplantationen
dc.typeArticleen
dc.contributor.departmentDepartment of Medicine, National University Hospital, Reykjavik, Iceland. margreta@rsp.isen
dc.identifier.journalKidney internationalen

Related articles on PubMed

All Items in Hirsla are protected by copyright, with all rights reserved, unless otherwise indicated.