Document Detail

Hyperhomocysteinemia is a significant risk factor for silent cerebral infarction in patients with chronic renal failure undergoing hemodialysis.
MedLine Citation:
PMID:  16631443     Owner:  NLM     Status:  MEDLINE    
In patients with chronic renal failure undergoing hemodialysis (HD), the presence of silent cerebral infarction (SCI) is associated with high mortality. Plasma total homocysteine (tHcy), which increases with renal dysfunction, has been flagged as a novel predictor for cerebrovascular events. We tested the hypothesis that the presence of SCI correlates with tHcy in HD patients. Based on brain magnetic resonance imaging findings, 44 patients undergoing HD were divided into a with-SCI group (61+/-9 years [mean+/-SD]; n=24) and a without-SCI group (60+/-8 years, n=20), in whom 24-hour ambulatory blood pressure monitoring was performed. The number of patients with diabetes or hypertension was not different between the 2 groups. We made the following observations: (1) the percentage of smokers was higher in the with-SCI group than in the without-SCI group (P<.05); (2) plasma levels of high-density lipoprotein cholesterol were lower and tHcy was higher in the with-SCI group than in the without-SCI group (P<.05 and P<.0001, respectively); (3) and systolic ambulatory blood pressure and mean heart rate during nighttime were higher in the with-SCI group than in the without-SCI group (P<.05). Multivariate logistic analysis identified hyperhomocysteinemia as an independent and significant risk factor for SCI (odds ratio, 1.22; 95% CI, 1.10-1.36; P<.01). Our findings indicate that plasma tHcy may be a novel useful predictor for SCI in patients with chronic renal failure undergoing HD.
Futoshi Anan; Naohiko Takahashi; Tsuyoshi Shimomura; Muneharu Imagawa; Kunio Yufu; Tomoko Nawata; Mikiko Nakagawa; Hidetoshi Yonemochi; Nobuoki Eshima; Tetsunori Saikawa; Hironobu Yoshimatsu
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Metabolism: clinical and experimental     Volume:  55     ISSN:  0026-0495     ISO Abbreviation:  Metab. Clin. Exp.     Publication Date:  2006 May 
Date Detail:
Created Date:  2006-04-24     Completed Date:  2006-06-01     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0375267     Medline TA:  Metabolism     Country:  United States    
Other Details:
Languages:  eng     Pagination:  656-61     Citation Subset:  IM    
Department of Cardiology, Oita Red Cross Hospital, and Department of Cardiovascular Science, School of Medicine, Oita University, Oita 879-5593, Japan.
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MeSH Terms
Blood Pressure Monitoring, Ambulatory
Cerebral Infarction / blood*
Cholesterol, HDL / blood
Echocardiography, Doppler
Heart Rate / physiology
Hyperhomocysteinemia / blood*
Kidney Failure, Chronic / blood*,  therapy*
Logistic Models
Magnetic Resonance Imaging
Middle Aged
Multivariate Analysis
Renal Dialysis*
Risk Factors
Reg. No./Substance:
0/Cholesterol, HDL

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