Document Detail

Homocysteine metabolism in renal disease.
MedLine Citation:
PMID:  14656019     Owner:  NLM     Status:  MEDLINE    
Hyperhomocysteinemia, a new cardiovascular risk factor, occurs in 85-100% of patients with end-stage renal disease. The exact mechanism by which renal function is linked to plasma homocysteine has not been definitively established. There is reasonably good clinical evidence that hyperhomocysteinemia in itself does not cause renal insufficiency. Two, not mutually exclusive, hypotheses are that in renal failure: i) homocysteine disposal is impaired in the kidneys themselves and ii) extra-renal homocysteine metabolism is defective, possibly due to uremic toxins. Several methods have been applied to investigate kidney and whole-body sulfur amino acid metabolism in healthy subjects and in patients with different degrees of renal failure. Arteriovenous extraction studies have not found a significant homocysteine disposal in the human kidney. Methods to study whole-body homocysteine metabolism have included measurement of plasma metabolites, calculation of plasma homocysteine elimination after oral loading and the use of stable isotope techniques with methionine tracers. The results implicate a decreased homocysteine clearance instead of an increased production as the cause of hyperhomocysteinemia in renal failure, but the exact site of the impaired clearance remains controversial.
Coen van Guldener; Coen D A Stehouwer
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Clinical chemistry and laboratory medicine : CCLM / FESCC     Volume:  41     ISSN:  1434-6621     ISO Abbreviation:  Clin. Chem. Lab. Med.     Publication Date:  2003 Nov 
Date Detail:
Created Date:  2003-12-05     Completed Date:  2004-02-06     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  9806306     Medline TA:  Clin Chem Lab Med     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1412-7     Citation Subset:  IM    
Department of Internal Medicine, Institute for Cardiovascular Research, Vrije Universiteit Medical Centre, Amsterdam, The Netherlands.
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MeSH Terms
Glomerular Filtration Rate / physiology
Homocysteine / metabolism*
Kidney Failure, Chronic / metabolism*,  physiopathology
Reg. No./Substance:

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