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Hyperhomocysteinemia predicts cardiovascular outcomes in hemodialysis patients
Open accessAbstract
BACKGROUND We prospectively tested the prediction power of homocysteinemia for all-cause and cardiovascular outcomes in a cohort of 175 hemodialysis patients followed for 29 +/- 12 months. METHODS Survival analysis was performed by the Cox's proportional hazard model and data were expressed as hazard ratio and 95% confidence interval (CI). RESULTS During the follow-up period 51 patients died, 31 of them (61%) of cardiovascular causes and 16 patients developed non-fatal atherothrombotic complications. Plasma total homocysteine was an independent predictor of cardiovascular mortality (P=0.01). Combined analysis of fatal and non-fatal atherothrombotic events showed that homocysteine was a strong and independent predictor of these outcomes because the risk of these events was 8.2 times higher (95% CI 1.9 to 32.2) in patients in the third homocysteine tertile than in those in the first tertile (P=0.005). CONCLUSIONS There is a clear association between hyperhomocysteinemia and incident cardiovascular mortality and atherothrombotic events in hemodialysis patients. Intervention studies are needed to determine whether the accumulation of this substance has a causal role in the pathogenesis of cardiovascular damage in patients undergoing hemodialysis.
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Cited by
Sarnak, M. J., Levey, A. S., Schoolwerth, A. C., Coresh, J., Culleton, B., Hamm, L. L., McCullough, P. A., Kasiske, B. L., Kelepouris, E., Klag, M. J., et al. (2003) · Circulation · doi:10.1161/01.cir.0000095676.90936.80 · Cited by 3,768
Sarnak, M. J., Levey, A. S., Schoolwerth, A. C., Coresh, J., Culleton, B., Hamm, L. L., McCullough, P. A., Kasiske, B. L., Kelepouris, E., Klag, M. J., et al. (2003) · Hypertension · doi:10.1161/01.hyp.0000102971.85504.7c · Cited by 1,144
Facts and recommendations about total homocysteine determinations: an expert opinion
Refsum, H., Smith, A. D., Ueland, P. M., Nexo, E., Clarke, R., McPartlin, J., Johnston, C., Engbaek, F., Schneede, J., McPartlin, C., et al. (2004) · Clinical Chemistry · doi:10.1373/clinchem.2003.021634 · Cited by 1,056
Pathophysiology of Vascular Calcification in Chronic Kidney Disease
Moe, S. M., & Chen, N. X. (2004) · Circulation Research · doi:10.1161/01.res.0000141775.67189.98 · Cited by 502
The uremic solutes p-cresol and indoxyl sulfate inhibit endothelial proliferation and wound repair
Dou, L., Bertrand, E., Cerini, C., Faure, V., Sampol, J., Vanholder, R., Berland, Y., & Brunet, P. (2004) · Kidney International · doi:10.1111/j.1523-1755.2004.00399.x · Cited by 489
Metadata
- Authors
- Mallamaci, F., Zoccali, C., Tripepi, G., Fermo, I., Benedetto, F. A., Cataliotti, A., Bellanuova, I., Malatino, L. S., & Soldarini, A.
- Venue
- Kidney International
- Publisher
- Elsevier BV
- Published
- 2002-02
- Volume
- 61
- Issue
- 2
- Pages
- 609-614
- ISSN
- 0085-2538 (ISSN-L)
- OpenAlex
- W2074334273
- Cited by
- 286
- References
- 0
- FWCI
- 18.07
- Type
- journal article
- Language
- en
- Open access
- bronze
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- Mallamaci, F., Zoccali, C., Tripepi, G., Fermo, I., Benedetto, F. A., Cataliotti, A., Bellanuova, I., Malatino, L. S., & Soldarini, A. (2002). Hyperhomocysteinemia predicts cardiovascular outcomes in hemodialysis patients. Kidney International. https://doi.org/10.1046/j.1523-1755.2002.00144.x
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