Abstract
Homocysteine has been seen to be directly related to the GFR. This is due to the fact that when renal function is compromised, the intra-renal homocysteine is downregulated, resulting in an increased level of circulating homocysteine. This is a contributory factor to the 30 times higher incidence of cardiovascular disease related deaths in the presence of end stage renal disease. In addition, there are reports of homocysteinemia-induced damage to the glomerular basement membrane through the modulation of MMP/TIMP axis which results in excessive oxidation of collagen IV in the membrane. Hence, it is important to address homocysteinemia in renal failure patients to prevent further co-morbidities.
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References
Cohen D, Galbraith C. General health management and long-term care of the renal transplant recipient. Am J Kidney Dis. 2001;38(6 supplement 6):S10–24.
Foley RN, Parfrey PS, Sarnak MJ. Clinical epidemiology of cardiovascular disease in chronic renal disease. Am J Kidney Dis. 1998;32(Suppl 3):S112–9.
Friedman AN, Bostom AG, Selhub J, Levey AS, Rosenberg IH. The kidney and homocysteine metabolism. JASN. 2001;12(10):2181–9.
Guttormsen AB, Ueland PM, Svarstad E, Refsum H. Kinetic basis of homocysteinemia in patients with chronic renal failure. Kidney Int. 1997;52:495–502.
House JD, Brosnan ME, Brosnan JT. Renal uptake and excretion of homocysteine in rats with acute homocysteinemia. Kidney Int. 1998;54(5):1601–7.
Samuelsson O, Lee DM, Attman PO, et al. The plasma levels of homocysteine are elevated in moderate renal insufficiency but do not predict the rate of progression. Nephron. 1999;82:306–11.
Sarnak MJ, Wang SR, Beck GJ, et al. Homocysteine, cysteine, and B vitamins as predictors of kidney disease progression. Am J Kidney Dis. 2002;40:932–9.
Sen U, Rodriguez WE, Tyagi N, Kumar M, Kundu S, Tyagi SC. Ciglitazone, a PPARγ agonist, ameliorates diabetic nephropathy in part through homocysteine clearance. Am J Phys. 2008;295(5):E1205–12.
Smolin LA, Laidlaw SA, Kopple JD. Altered plasma free and protein-bound sulphur amino acid levels in patients undergoing maintenance hemodialysis. Am J Clin Nutr. 1987;45:737–43.
Wilcken DEL, Dudman NPB, Tyrell PA, Robertson MR. Folic acid lowers plasma homocysteine in chronic renal insufficiency: possible implication for prevention of vascular disease. Metabolism. 1988;37(7):697–701.
Wollesen F, Brattstrom L, Refsum H, Ueland PM, Berglund L, Berne C. Plasma total homocysteine and cysteine in relation to glomerular filtration rate in diabetes mellitus. Kidney Int. 1999;55:1028–35.
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Bhargava, S. (2018). Homocysteinemia in Nephrology Practice. In: The Clinical Application of Homocysteine. Springer, Singapore. https://doi.org/10.1007/978-981-10-7632-9_6
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DOI: https://doi.org/10.1007/978-981-10-7632-9_6
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