Background: Plasma homocysteine (Hey) is an independent risk factor for cardiovascular disease. High levels of plasma Hey have been observed in end-stage renal disease patients. Few studies have compared peritoneal dialysis (PD) and hemodialysis (HD) patients and few data are available on erythrocyte folate (ery-F) levels in dialysis patients. Objectives: To evaluate plasma Hey concentrations, vitamin B12 (B12), and folate status in dialysis patients; to analyze the possible causes of high Hey levels; to follow up changes in folate and B12 concentrations after 6 months. Design: A cross-sectional observational study. Setting: Nephrology division and laboratory of hematology in a university and clinical research hospital. Patients: The study included 82 patients treated with PD for 37 ± 37 months and 70 patients treated with HD for 136 ± 95 months. Laboratory Methods: Plasma Hey was measured by the immunoenzymatic IMx Hey FPIA method (Abbott Laboratories, Diagnostic Division, Abbott Park, IL, U.S.A.), serum folate (s-F) and ery-F by the Stratus folate fluorometric enzyme-linked assay, and B12 by the Stratus vitamin B12 fluorometric enzyme-linked assay (DADE-Behring, Newark, DE, U.S.A.). Results: Ninety-six percent of PD and 97% of HD patients had Hey levels above the cutoff (13.5 μmol/L). Homocysteine level was higher in HD than in PD patients, while the prevalence of hyperhomocysteinemia was similar with the two techniques. Erythrocyte folate was significantly higher in PD (1333 ± 519 pmol/L) than in HD (1049 ± 511 pmol/L, p <0.01). Statistically significant correlations were observed between Hey and B12, s-F, ery-F, and dialysis duration. Multivariate analysis showed a strong correlation between s-F and Hey. After 6 months there were no differences in Hey, B12, s-F, and ery-F levels. Conclusions: Plasma Hey levels were high in more than 95% of our dialysis patients, with no relation to the type of dialysis. Vitamin B12 and folate were normal in the majority of our patients. However, serum folate was the major determinant of Hey levels. Such a relation between Hey and folate suggests that levels of folate within the reference interval are inadequate for dialysis patients.
|Number of pages||5|
|Journal||Peritoneal Dialysis International|
|Publication status||Published - 2000|
- Erythrocyte folate
- Serum folate
- Vitamin B
ASJC Scopus subject areas