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Hyperhomocysteinemia increases the risk of chronic kidney disease in a Chinese middle-aged and elderly population-based cohort

International Urology and Nephrology volume 49, pages 661–667 (2017)Cite this article

Abstract

Background

Patients either with hyperhomocysteinemia or chronic kidney disease (CKD) have an increased risk of cardiovascular disease. Little is known regarding whether hyperhomocysteinemia can increase the risk of CKD in a Chinese middle-aged and elderly population. To help clarify this we conducted a prospective cohort study to measure the association of hyperhomocysteinemia with CKD.

Methods

A total of 5917 adults aged 56.4 ± 9.6 years without CKD at baseline were enrolled. The highest homocysteine quartile (≥15 μmol/L) was defined as hyperhomocysteinemia. CKD was defined as decreased estimated glomerular filtration rate (eGFR < 60 mL/min/1.73 m2) or presence of proteinuria (urine protein ≥ 1+) assessed using a repeated dipstick method.

Results

During 3 years of follow-up, 143 (2.4%) patients developed CKD, 85 (1.4%) patients with proteinuria and 59 (1.0%) patients with decreased eGFR. After adjusted for potential confounders, both homocysteine (per 1 μmol/L increase) and hyperhomocysteinemia were independently associated with increased risk of decreased eGFR [with a fully adjusted OR of 1.07 (95% CI 1.04–1.10) and 3.05 (95% CI 1.71–5.46)] and CKD [with a fully adjusted OR of 1.04 (95% CI 1.02–1.07) and 1.62 (95% CI 1.11–2.35)], respectively. By contrast, neither homocysteine (per 1 μmol/L increase) nor hyperhomocysteinemia were associated with proteinuria in the multivariable logistic regression analysis.

Conclusions

The study revealed that hyperhomocysteinemia increases the risk of decreased eGFR. This suggests that homocysteine could be considered as a useful molecular markers for delaying the development of CKD.

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Acknowledgements

The research for this study was supported by the Key Science and Technology Research Projects from the natural science foundation of Shandong Province (2013GSF11818).

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    Affiliations

    1. Department of Nephrology, Qianfoshan Hospital, Shandong University, No. 16766, Jingshi Road, Jinan, 250014, People’s Republic of China

      Xianglei Kong, Hong Su & Dongmei Xu

    2. Department of Health Examination Center, Qianfoshan Hospital, Shandong University, No. 16766, Jingshi Road, Jinan, 250014, People’s Republic of China

      Xiaojing Ma

    3. Department of Nephrology, Yidu Central Hospital, Weifang Medical College, No. 4138, South Road of Linglong Mountain, Qingzhou, People’s Republic of China

      Chengyin Zhang

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    1. Xianglei Kong
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    2. Xiaojing Ma
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    Correspondence to Dongmei Xu.

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    Xianglei Kong and Xiaojing Ma have contributed equally to this work.

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    Kong, X., Ma, X., Zhang, C. et al. Hyperhomocysteinemia increases the risk of chronic kidney disease in a Chinese middle-aged and elderly population-based cohort. Int Urol Nephrol 49, 661–667 (2017). https://doi.org/10.1007/s11255-016-1452-3

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    • DOI: https://doi.org/10.1007/s11255-016-1452-3

    Keywords

    • Hyperhomocysteinemia
    • Chronic kidney disease
    • Proteinuria
    • Estimated glomerular filtration rate
    • Epidemilogy