European Journal of Molecular & Clinical Medicine

Abstract

Background & Objectives: Chronic kidney disease (CKD) is a commonly seen clinical condition resulting from different etiologies, diabetes and hypertension contributing to majority of CKD. Hyperhomocysteinemia is observed in CKD, which contributes to increased cardiovascular morbidity and mortalities according to many studies. Reduction of homocysteine level may help to decrease the cardiovascular morbidity and mortality which are leading cause of death in CKD patients.
Material and Methods: 90 patients with diabetes and/or hypertension, diagnosed as CKD with eGFR <90ml/min visiting the hospitals attached to BMCRI were chosen and their fasting plasma homocysteine level were measured. Patients less than 18 years age and had history of cerebral vascular disease, coagulopathy, Alzheimer’s disease were excluded from the study. The data was summarized using mean, standard deviation for parametric data and median, interquartile range for non-parametric data and chi-square test was used for analyzing categorical variables.
Results: Hyperhomocysteinemia was observed in 63.33% of patients with CKD, majority of patients (26.3%) belonged to 50-59 years age group with a significant male (73.7%) preponderance in CKD with hyperhomocysteinemia group. Prevalence of Diabetes and Hypertension in CKD with hyperhomocysteinemia were 73.7% and 82.5% respectively and with a mean duration of Diabetes and Hypertension of 9.82 ± 7.073 years and 7.3 ± 6.545 years respectively. 12.3% patients in CKD with hyperhomocysteinemia were found to have underlying causes for CKD, among them around 57.1% of them had Chronic Interstitial Nephritis. Prevalence of hyperhomocysteinemia was more in end stages of CKD i.e. stage 3B (8.8%), stage 4 (15.8%) & stage 5 (75.4%). Homocysteine elevation was found in both CKD without dialysis and with intermittent hemodialysis.
Conclusion: Serum homocysteine levels appear to be closely associated with CKD and serum homocysteine levels are negatively associated with GFR. Thereby, serum homocysteine levels can be used as a marker of renal dysfunction in patients with diabetes and hypertension.