Hyperhomocysteinaemia in Children with Chronic Renal Insufficiency

Overview

A raised plasma concentration of homocysteine - hyperhomocysteinaemia - is considered an independent risk factor of atherosclerosis. Chronic renal insufficiency (CHRI) leads to impaired homocysteine metabolism and is frequently associated also with deficiency of vitamins important in the process of homocysteine breakdown. This increases the risk of cardiovascular damage in these patients.In the submitted investigation the authors examined in 33 children with different grades of CHRI (16 children with conservative treatment, 10 children in a dialyzation programme and 7 children after renal transplantation) the plasma concentration of homocysteine, folic acid, and vitamin B12 serum creatinine, BMI and serum albumin. In all three groups of patients the homocysteine concentrations were significantly higher than in healthy children (17.84 ± 3.89 vs 7.75 ± 2.42 mmol/l, p < 0.001). The mean plasma homocysteine concentration in children with conservative treatment was 15.8 ± 2.53 mmol/l, in dialyzed children 18.99 ± 6.56 mmol/l and 20.87 ± 2.41 mmol/l in children after renal transplantation. In patients during the predialyzation period and those on dialysis the authors found a significant correlation between plasma homocysteine and serum creatinine (r = 0.41, p < 0.05). Vitamin B12 and folic acid deficiency was not observed in the examined children and no significant correlation was found between plasma homocysteine and vitamin concentrations. In the investigated patients hyperhomocysteinaemia thus was not conditioned by vitamin B12 and folic acid deficiency.

Key words:
hyperhomocysteinaemia, vitamin B12, folic acid, chronic renal insufficiency, children