DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20202265

Study of serum homocysteine level in patients with chronic kidney disease and its association with renal function and serum albumin

Vandana Yadav, Vivek Prakash, Bushra Fiza, Maheep Sinha

Abstract


 

Background: Chronic kidney disease (CKD) includes irreversible destruction of nephrons leading to progressive decline in glomerular filtration rate. A preferential defect in Homocysteine disposal could hypothetically occur in CKD and subsequently lead to hyperhomocysteinemia. Understanding the status of Homocysteine and other parameters in CKD is useful in the management of the disease. Objective of the study is to estimate serum Homocysteine in CKD patients and its association with renal function and serum albumin in patients with CKD.

Methods: The study design involves hospital based observational comparative study. The study was conducted in Department of Biochemistry in association with Department of Nephrology of Mahatma Gandhi Medical College and Hospital, Jaipur between May 2017 to June 2018. 100 diagnosed patients of CKD, visiting the Outpatient Department of Nephrology were enrolled as cases for the study. Patients having cardiovascular disease, Chronic liver disease, Age more than 60 years and pregnant females were excluded from study. The control group consists of 100 age and sex matched healthy individuals.

Results: The mean serum creatinine levels of case and control group were 7.50±3.74 mg% and 0.83±0.22 mg% respectively. The mean of serum homocysteine levels of subject group was 27.35±12.52 µmol/L while the mean serum homocysteine levels of control group was 11.06±3.52 µmol/L. The serum homocysteine levels were significantly higher in the CKD patient group. The serum level of albumin in CKD patients and control group were 2.86±0.86 g/dl and 4.10±0.58 g/dl respectively. A positive correlation was found between serum creatinine and serum homocysteine levels. A negative correlation between serum homocysteine and serum albumin was found.

Conclusions: Findings of the present study exhibit that serum homocysteine levels are elevated in CKD in comparison to healthy controls and it is positively correlated with serum creatinine level.


Keywords


Albumin, Jaipur, Amino acid, Chronic kidney disease, Homocysteine

Full Text:

PDF

References


Agarwal SK, Srivastava RK. Chronic kidney disease in India: challenges and solutions. Nephr Clini Pract. 2009;111(3):c197-203.

Shipchandler MT, Moore EG. Rapid, fully automated measurement of plasma homocysteine with the Abbott IMxanalyzer. Clin Chem. 1995 Jul 1;41(7):991-4.

Ueland PM, Mansoor MA, Guttormsen AB, Müller F, Aukrust P, Refsum H, et al. Reduced, oxidized and protein-bound forms of homocysteine and other amino thiols in plasma comprise the redox thiol statusa possible element of the extracellular antioxidant defense system. J Nutr. 1996 Apr 1;126(suppl_4):1281S-4S.

Graham IM, Daly LE, Refsum HM, Robinson K, Brattström LE, Ueland PM, et al. Plasma homocysteine as a risk factor for vascular disease: the European Concerted Action Project. JAMA. 1997 Jun 11;277(22):1775-81.

Refsum H, Helland S, Ueland PM. Radioenzymic determination of homocysteine in plasma and urine. Clini Chem. 1985 Apr 1;31(4):624-8.

House JD, Brosnan ME, Brosnan JT. Renal uptake and excretion of homocysteine in rats with acute hyperhomocysteinemia. Kidney Int. 1998 Nov 1;54(5):1601-7.

Van Guldener C, Donker AJ, Jakobs C, Teerlink T, de Meer K, Stehouwer CD. No net renal extraction of homocysteine in fasting humans. Kidney Int. 1998 Jul 1;54(1):166-9.

Garibotto G, Sofia A, Saffioti S, Russo R, Deferrari G, Rossi D, et al. Inter organ exchange of aminothiols in humans. Am J Physiol-Endocrinol Metab. 2003 Apr 1;284(4):E757-63.

Tizianello A, De Ferrari G, Garibotto G, Gurreri G, Robaudo C. Renal metabolism of amino acids and ammonia in subjects with normal renal function and in patients with chronic renal insufficiency. J Clin Invest. 1980;65(5):1162-73.

Vieira AD, Baptista A, Malho A, Pinho A, Silva AP, Bernardo I, et al. Homocysteine is a risk factor in predialysis patients when associated with malnutrition and inflammation. Int J Nephrol.2010;10:4061.

Kopple JD. National kidney foundation K/DOQI clinical practice guidelines for nutrition in chronic renal failure. Am J Kidney Dis. 2001 Jan 1;37(1):S66-70.

Kidney Disease: Improving Global Outcomes (KDIGO) CKD-MBD Work Group. KDIGO clinical practice guideline for the diagnosis, evaluation, prevention, and treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD). Kidney Int. Supplement. 2009 Aug(113):S1.

Prakash S, O'Hare AM. Interaction of aging and chronic kidney disease. SeminNephrol. 2009 Sep;29(5): 497-503.

Goldberg I, Krause I. The role of gender in chronic kidney disease. EMJ. 2016;1(2):58-64.

Guest S. Hypoalbuminemia in peritoneal dialysis patients. Adv Periton Dialys. 2013;29:55-60.

James WP, Hay AM. Albumin metabolism: effect of the nutritional state and the dietary protein intake. J Clini Investigat. 1968 Sep 1;47(9):1958-72.

Li J, Shi M, Zhang H, Yan L, Xie M, Zhuang L, et al. Relation of homocysteine to early nephropathy in patients with Type 2 diabetes. Clin Nephrol. 2012 Apr;77(4):305-10.

Friedman AN, Bostom AG, Selhub J, Levey AS, Rosenberg IH. The kidney and homocysteine metabolism. J Am Soc Nephrol. 2001;12(10):2181-9.