Elsevier

Kidney International

Volume 53, Issue 6, June 1998, Pages 1775-1782
Kidney International

Original Article
Major determinants of hyperhomocysteinemia in peritoneal dialysis patients

https://doi.org/10.1046/j.1523-1755.1998.00918.xGet rights and content
Under an Elsevier user license
open archive

Major determinants of hyperhomocysteinemia in peritoneal dialysis patients. The mechanisms leading to elevated total homocysteine concentrations in peritoneal dialysis patients are only partially understood. We show that a common polymorphism in the 5,10-methylenetetrahydrofolate reductase (MTHFR) gene (C677T transition) results in increased total homocysteine levels in peritoneal dialysis patients compared to age- and sex-matched healthy individuals. The allelic frequency of the C677T transition in the MTHFR gene in peritoneal dialysis patients (0.29) was comparable to the frequency in healthy individuals (0.34). Separate comparison of the total homocysteine plasma levels between non-carriers of the MTHFR polymorphism (C/C), heterozygous (C/T) and homozygous (T/T) subjects was performed by analysis of covariance in the patient and the control group. In the patient group the mean total homocysteine level was 61.7 ± 40.1 μmol/liter in individuals with the (T/T) genotype, which was significantly higher than the total homocysteine concentration of 23.1 ± 15.8 μmol/liter in (C/T) patients and 22.2 ± 11.1 μmol/liter for non-carriers (P = 0.0001). Vitamin B12 (P = 0.0001), folate (P = 0.0005), serum creatinine (P = 0.016), albumin (P = 0.0157) and dialysis center (P = 0.0173) significantly influenced total homocysteine plasma levels in peritoneal dialysis patients, whereas this was not the case for age, gender, weekly Kt/V, weekly creatinine clearance, residual renal function, duration of dialysis, mode of peritoneal dialysis and vitamin intake. Folate levels in peritoneal dialysis patients were significantly affected by the MTHFR genotype (P = 0.016). Elevated total homocysteine levels in diabetic patients with cardiovascular disease were associated with increased cardiovascular morbidity. In summary, the present study provides evidence that homozygosity for the C677T transition in the MTHFR gene, low vitamin B12 and low folate levels result in elevated total homocysteine levels in peritoneal dialysis patients.

Keywords

total homocysteine
peritoneal dialysis
methylenetetrahydrofolate reductase
polymorphism
mutation
folate
vitamin B12

Cited by (0)