The Effect of Elevated Homocysteine Levels on Atherosclerosis in Patients with Peritoneal Dialysis

Year 2016, , 47 - 51, 01.03.2016

Fatih Şahpaz

https://doi.org/10.5799/jcei.328680

Abstract

Objective: Cardiovascular disease is an important cause of morbidity and mortality in patients with renal failure. Patients
with chronic renal failure are significantly susceptible to atherosclerosis. In the present study, we aimed to investigate
the effect of elevated homocysteine on atherosclerosis and inflammation in continuos ambulatory peritoneal
dialysis (CAPD) patients.
Methods: 56 patients undergoing CAPD and 27 healthy subjects was enrolled in the study. All patients total cholesterol,
triglyceride, LDL cholesterol, HDL cholesterol, hs-CRP, homocysteine, intima-media thickness, arterial stiffness values
were measured and statistically analyzed.
Results: It is determined that the levels of total cholesterol, triglyceride, LDL cholesterol, HDL cholesterol, homocysteine,
intima-media thickness, arterial stiffness and hs-CRP was higher in patients compared to the control group (in order;
p=0.03, p=0.0006, p=0.02).
Conclusion: Carotid intima-media thickness being increased because of increased levels of homocysteine and inflammation
in CAPD patients. Therefore, in case of atherosclerosis, hyperlipidemia and inflammation more aggressive treatment
protocol should be considered. Patients with elevated plasma homocysteine concentrations should be treated. J
Clin Exp Invest 2016; 7 (1): 47-51

Keywords

İnflamasyon, homosistein, intima media kalınlığı, arteriyel sertlik

References

• 1. Johansson AC, Samuelsson O, Attman PO, et al. Dyslipidemia in peritoneal dialysis-relation to dialytic variables. Perit Dial Int 2000;20:306-314.
• 2. Attman PO, Samuelsson OG, Moberly J, et al. Apolipoprotein B-containing lipoproteins in renal failure: the relation to mode of dialysis. Kidney Int 1999;55:1536-1542.
• 3. Moberly JB, Attman PO, Samuelsson O, et al. Alterations in lipoprotein composition in peritoneal dialysis patients. Perit Dial Int 2002;22:220-228.
• 4. Attman PO, Samuelsson OG, Moberly J, et al. Apolipoprotein B-containing lipoproteins in renal failure: the relation to mode of dialysis. Kidney Int 1999;55:1536-1542.
• 5. Ross R. Atherosclerosis- An inflammatory disease. N Engl J Med 1999;340:115-126.
• 6. Aydın M, Selcoki Y, Nazlı Y, et al. Relationship between total antioxidant capacity and the severity of coronary artery disease. J Clin Exp Invest 2012;3:22-28.
• 7. De Lorgeril M, Renaud S, Mamelle N, et al. Mediterranean α-linolenic asid rich diet in secondary prevention of coronay heart disease. Lancet 1994;343:1454-1459.
• 8. Siamopoulos KC, Elisaf M. Is CAPD atherogenic? Perit Dial Int 1997;17:227-231.
• 9. Zoccali C, Mallamaci F, Tripepi G. Inflammatory proteins as predictors of cardiovascular disease in patients with endstage renal disease. Nephrol Dial Transplant 2004;19:67- 72.
• 10. Özdemir FN, Güz G, Sezer S, et al. Atherosclerosis risk is higher in continuous ambulatory peritoneal dialysis patients than in hemodialysis patients. Artif Organs 2001;25:448- 452.
• 11. Avram MM, Fein PA, Antignani A, et al. Cholesterol and lipid disturbances in renal disease: the natural history of uremic dyslipidemia and the impact of hemodialysis and continuous ambulatory peritoneal dialysis. Am J Med 1989;87:55-60.
• 12. Stenvinkel P, Lindholm B. C-reactive protein in end-stage renal disease: are there reasons to? Blood Purif 2005;23:72- 78.
• 13. Chauveau P, Chadefaux B. Hyperhomocysteinemia, a risk factor for arteriosclerosis in chronic uremic patients. Kidney Int 1993;43:72-77.
• 14. Bostom AG, Lathrop L. Hyperhomocysteinemia in end stage renal disease: Prevalance, etiology and potential relationship to arteriosclerotic outcomes. Kidney Int 1997;52:10-20.
• 15. Maeda N, Sawayama Y, Tatsukawa M, et al. Carotid artery lesions and atherosclerotic risk factors in Japanese hemodialysis patients. Atherosclerosis 2003;169:183-192.
• 16. Kawagishi T, Nishizawa Y, Konishi T, et al. High-resolution B-mode ultrasonography in evaluation of atherosclerosis in uremia. Kidney Int 1995;48: 820-826.
• 17. Leskinen Y, Lehtimaki T, Loimaala A, et al. Carotid atherosclerosis in chronic renal failure-the central role of increased plaque burden. Atherosclerosis 2003;171:295-302.
• 18. Salonen R, Haapanen A, Salonen JT. Measurement of intima-media thickness of common carotid arteries with highresolution B-mode ultrasonography: inter and intra observer variability. Ultrasound Med Biol 1991;17:225-230.
• 19. Dagli N, Poyrazoglu OK, Dagli AF, et al. Is inflammatory bowel disease a risk factor for early atherosclerosis? Angiology 2010;6:198-204.
• 20. Aygen B, Dogukan A, Dursun FE, et al. Ghrelin and obestatin levels in end-stage renal disease. J Int Med Res 2009:37:757-765.
• 21. Şahpaz F, Ulutaş KT. Assessment of mean platelet volume in type 2 diabetics receiving insulin or oral antidiabetic agents. Dicle Med J 2015;42:399-403.