Cardiovascular diseases connected with
atherosclerosis are the main factor of morbidity and mortality in patients with
end-stage renal failure.
Hyperhomocysteinemia is a known and independent risk factor of
atherosclerosis, occurring in 85-95% patients treated with
hemodialysis. The aim of this study was to analyse relation between plasma level of
homocysteine and chosen indicators of
atherosclerosis development and also examined retrospectively cardiovascular complications in these patients. The study was carried out in 100 patients on
hemodialysis who were divided into two groups: 72 patients with mild (20.74 mumol/l +/- 3.75) and 28 patients with moderate
hyperhomocysteinemia (38.81 mumol/l +/- 9.81). Ultrasonographic examinations of Carotid Communis Artery Intima-Media Thickness (IMT), Ankle-Arm Blood Pressure Index (AABPI), echocardiographic parameters and biochemical examinations such as: PTH,
folic acid and
Vitamin B12, total
protein,
albumin,
fibrinogen,
glucose, total,
LDL and
HDL cholesterol, transferring,
apolipoprotein B,
lipoprotein (a),
sodium potassium,
calcium, phosphate,
magnesium,
iron,
ferritin,
urea,
creatinine,
uric acid and value of Hb, Ht, total
iron binding capacity and transferring saturation, were performed. Patients with
hypertension were divided into groups according to the number of taken
anti-hypertensive drugs.
Hyperhomocysteinemia was confirmed in 96% of patients. Frequency and type of acute cardiovascular complications were not related with the level of
hyperhomocysteinemia. Statistically significant difference between IMT and level of
hyperhomocysteinemia was observed. In patients with mild
hyperhomocysteinemia IMT was 0.68 mm +/- 0.24 whereas in patients with moderate
hyperhomocysteinemia 0.80 mm +/- 0.25, p < 0.036). Positive correlation between level of
homocysteine and IMT (r = 0.22, p < 0.03) was noted. Based on this study, we concluded, that measurement of intima-media thickness is a good
indicator of
atherosclerosis development and correlates with
hyperhomocysteinemia in patients on maintenance
hemodialysis. It clearly confirms the role of
hyperhomocysteinemia as significant risk factor of
atherosclerosis in those patients.