NDT Advance Access originally published online on October 12, 2004
Nephrology Dialysis Transplantation 2005 20(1):16-21; doi:10.1093/ndt/gfh447
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Nephrol Dial Transplant Vol. 20 No. 1 © ERA-EDTA 2005; all rights reserved
Editorial Review
Homocysteine in uraemia—a puzzling and conflicting story
1 Division of Renal Medicine and Baxter Novum, Department of Clinical Science, Karolinska University Hospital at Huddinge, Stockholm, Sweden and 2 Division of Nephrology and Hypertension, Harbor-UCLA Medical Center, Torrance, CA 90509, USA
Correspondence and offprint requests to: Peter Stenvinkel, MD, PhD, Department of Renal Medicine, K56, Karolinska University Hospital Huddinge, 141 86 Stockholm, Sweden. Email: peter.stenvinkel@klinvet.ki.se
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Introduction |
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Homocysteine (Hcy) is a non-protein sulfur-containing amino acid that consists of various forms: a protein-bound fraction (70–80%), a free oxidized form (20–30%) and a free reduced form (
1%), which recently has attracted considerable interest as it may, by several mechanisms (Table 1) mediate premature atherosclerosis and cardiovascular disease (CVD). Indeed, in the general population, the results have shown that even mildly elevated plasma total homocysteine (tHcy) levels are associated with an increased cardiovascular risk [1–3]. However, not all prospective cohort studies are consistent with this finding [2] and, so far, the result of a large vitamin intervention study is not promising [4].
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The normal range of tHcy is 3–15 µmol/l, and many factors may influence this level [5]. Beside nutritional deficiencies of B vitamins and genetic factors (C677T mutation of
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Is homocysteine a vascular risk factor in ESRD? |
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Homocysteine is associated with nutritional and inflammatory biomarkers |
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Diabetes mellitus (DM) may also influence the association between tHcy and outcome |
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Homocysteine—another case of reverse epidemiology in ESRD |
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Do patients reaching dialysis treatment constitute a group of survivors? |
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Conclusion |
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