Document Detail

Hyperhomocysteinemia in chronic renal failure patients: relation to tissue factor and platelet aggregation.
MedLine Citation:
PMID:  16509458     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: A moderate increase in plasma total homocysteine (t-hcy) is considered to be an independent risk factor for cardiovascular disease (CVD) in general population. One of the mechanisms by which hyperhomocysteinemia contributes to cardiovascular risk has been explained to be the increased thrombotic potential. Elevated t-hcy levels were also reported in chronic renal failure patients because the renal function is a major determinant of serum t-hcy levels.
PATIENTS AND METHODS: We measured serum hcy and ADP-induced platelet aggregation and plasma tissue factor as a major activator of the coagulation cascade in hemodialysis (HD), peritoneal dialysis (PD) and early stage chronic renal failure (early stage CRF) patients who are not receiving dialysis and compared with those of control. In addition, we also determined serum vitamin B12 and folat levels which are the important factors regulating the metabolism of t-hcy.
RESULTS: Hcy levels in all patient groups were significantly higher (HD: 20.42 +/- 1.91 micromol/l, PD: 35.47 +/- 6.30, early stage CRF: 24.39 +/- 3.06) than the normal levels (10.74 +/- 0.74) in spite of standard multivitamin supplementation. The highest t-hcy values were found in peritoneal dialysis patients. Vitamin B12 levels in hemodialysis/peritoneal dialysis patients and folat levels in hemodialysis/early stage CRF patients were also significantly above those of control. On the other hand, the significant elevations in plasma tissue factor concentration were found in all patient groups (HD: 331.4 +/- 31.3 pg/ml, PD: 306.0 +/- 30.0, early stage CRF: 277.2 +/- 25.5 and
CONTROL: 69.5 +/- 13.5). t-hcy levels were positively correlated with creatinine (r: 0.791 p < 0.002) and tissue factor levels (r: 0.526 p < 0.05) in only early stage CRF group. The association between t-hcy and tissue factor persisted after these two parameters were adjusted for creatinine (r: 0.649 p < 0.05). On the other hand the same correlations were not observed in dialysis patient groups. In spite of the high tissue factor levels, ADP-induced platelet aggregations were found to be lower in all patient groups (HD: 102.6 +/- 6.7, PD: 98.6 +/- 7.6 and Early stage CRF: 84.9 +/- 7.6) than controls (154.9 +/- 13.7).
CONCLUSION: These results suggest that hyperhomocysteinemia and increased tissue factor level are present in patients with renal failure, despite supplementation with vitamin B6 and B12 and folat. However, elevated levels of these thrombogenic factors are not linked with platelet aggregation.
O Cetin; S Bekpinar; Y Unlucerci; A Turkmen; C Bayram; T Ulutin
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical nephrology     Volume:  65     ISSN:  0301-0430     ISO Abbreviation:  Clin. Nephrol.     Publication Date:  2006 Feb 
Date Detail:
Created Date:  2006-03-02     Completed Date:  2006-06-08     Revised Date:  2014-07-29    
Medline Journal Info:
Nlm Unique ID:  0364441     Medline TA:  Clin Nephrol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  97-102     Citation Subset:  IM    
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MeSH Terms
Case-Control Studies
Chromatography, High Pressure Liquid
Enzyme-Linked Immunosorbent Assay
Folic Acid / administration & dosage,  blood
Homocysteine / blood
Hyperhomocysteinemia / blood*
Kidney Failure, Chronic / blood*,  therapy
Platelet Aggregation*
Renal Dialysis
Thromboplastin / metabolism*
Vitamin B 12 / administration & dosage,  blood
Vitamin B 6 / administration & dosage,  blood
Reg. No./Substance:
0LVT1QZ0BA/Homocysteine; 8059-24-3/Vitamin B 6; 9035-58-9/Thromboplastin; 935E97BOY8/Folic Acid; P6YC3EG204/Vitamin B 12

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