Homocysteine Metabolism in Renal Disease
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Abstract
Hyperhomocysteinemia, a new cardiovascular risk factor, occurs in 85–100% of patients with end-stage renal disease. The exact mechanism by which renal function is linked to plasma homocysteine has not been definitively established. There is reasonably good clinical evidence that hyperhomocysteinemia in itself does not cause renal insufficiency. Two, not mutually exclusive, hypotheses are that in renal failure: i) homocysteine disposal is impaired in the kidneys themselves and ii) extra-renal homocysteine metabolism is defective, possibly due to uremic toxins. Several methods have been applied to investigate kidney and whole-body sulfur amino acid metabolism in healthy subjects and in patients with different degrees of renal failure. Arteriovenous extraction studies have not found a significant homocysteine disposal in the human kidney. Methods to study whole-body homocysteine metabolism have included measurement of plasma metabolites, calculation of plasma homocysteine elimination after oral loading and the use of stable isotope techniques with methionine tracers. The results implicate a decreased homocysteine clearance instead of an increased production as the cause of hyperhomocysteinemia in renal failure, but the exact site of the impaired clearance remains controversial.
Copyright © 2003 by Walter de Gruyter GmbH & Co. KG
Articles in the same Issue
- Where Are We Standing in Homocysteine Research?
- DACH-LIGA Homocystein (German, Austrian and Swiss Homocysteine Society): Consensus Paper on the Rational Clinical Use of Homocysteine, Folic Acid and B-Vitamins in Cardiovascular and Thrombotic Diseases: Guidelines and Recommendations
- Hyperhomocysteinaemia as a Risk Factor for Venous Thrombosis: An Update of the Current Evidence
- Does Homocysteine Cause Hypertension?
- Homocysteine Metabolism in Renal Disease
- Hyperhomocysteinemia and B-Vitamin Deficiencies in Infants and Children
- The Role of Genetic Factors in the Development of Hyperhomocysteinemia
- New Basis of the Neurotrophic Action of Vitamin B12
- Hyperhomocysteinemia and Immune Activation
- Interactions of Homocysteine, Nitric Oxide, Folate and Radicals in the Progressively Damaged Endothelium
- Influence of Hyperhomocysteinemia on the Cellular Redox State – Impact on Homocysteine-Induced Endothelial Dysfunction
- Homocysteine-Thiolactone and S-Nitroso-Homocysteine Mediate Incorporation of Homocysteine into Protein in Humans
- Association of Asymmetric Dimethylarginine and Endothelial Dysfunction
- Genetic Determinants of Folate and Vitamin B12 Metabolism: A Common Pathway in Neural Tube Defect and Down Syndrome?
- Functional Vitamin B12 Deficiency and Determination of Holotranscobalamin in Populations at Risk
- Holotranscobalamin as a Predictor of Vitamin B12 Status
- Hyperhomocysteinemia and B-Vitamin Status after Discontinuation of Oral Anticoagulation Therapy in Patients with a History of Venous Thromboembolism
- Measurement of Carotid Plaque and Effect of Vitamin Therapy for Total Homocysteine
- Folate Improves Endothelial Function in Patients with Coronary Heart Disease
- The Impact of Hyperhomocysteinemia as a Cardiovascular Risk Factor in the Prediction of Coronary Heart Disease
- Homocysteine Increases during Endurance Exercise
- Comparison of the Influence of Volume-Oriented Training and High-Intensity Interval Training on Serum Homocysteine and Its Cofactors in Young, Healthy Swimmers
- Analysis of the Transcobalamin II 776C>G (259P>R) Single Nucleotide Polymorphism by Denaturing HPLC in Healthy Elderly: Associations with Cobalamin, Homocysteine and Holo-Transcobalamin II
- Meetings and Awards
Articles in the same Issue
- Where Are We Standing in Homocysteine Research?
- DACH-LIGA Homocystein (German, Austrian and Swiss Homocysteine Society): Consensus Paper on the Rational Clinical Use of Homocysteine, Folic Acid and B-Vitamins in Cardiovascular and Thrombotic Diseases: Guidelines and Recommendations
- Hyperhomocysteinaemia as a Risk Factor for Venous Thrombosis: An Update of the Current Evidence
- Does Homocysteine Cause Hypertension?
- Homocysteine Metabolism in Renal Disease
- Hyperhomocysteinemia and B-Vitamin Deficiencies in Infants and Children
- The Role of Genetic Factors in the Development of Hyperhomocysteinemia
- New Basis of the Neurotrophic Action of Vitamin B12
- Hyperhomocysteinemia and Immune Activation
- Interactions of Homocysteine, Nitric Oxide, Folate and Radicals in the Progressively Damaged Endothelium
- Influence of Hyperhomocysteinemia on the Cellular Redox State – Impact on Homocysteine-Induced Endothelial Dysfunction
- Homocysteine-Thiolactone and S-Nitroso-Homocysteine Mediate Incorporation of Homocysteine into Protein in Humans
- Association of Asymmetric Dimethylarginine and Endothelial Dysfunction
- Genetic Determinants of Folate and Vitamin B12 Metabolism: A Common Pathway in Neural Tube Defect and Down Syndrome?
- Functional Vitamin B12 Deficiency and Determination of Holotranscobalamin in Populations at Risk
- Holotranscobalamin as a Predictor of Vitamin B12 Status
- Hyperhomocysteinemia and B-Vitamin Status after Discontinuation of Oral Anticoagulation Therapy in Patients with a History of Venous Thromboembolism
- Measurement of Carotid Plaque and Effect of Vitamin Therapy for Total Homocysteine
- Folate Improves Endothelial Function in Patients with Coronary Heart Disease
- The Impact of Hyperhomocysteinemia as a Cardiovascular Risk Factor in the Prediction of Coronary Heart Disease
- Homocysteine Increases during Endurance Exercise
- Comparison of the Influence of Volume-Oriented Training and High-Intensity Interval Training on Serum Homocysteine and Its Cofactors in Young, Healthy Swimmers
- Analysis of the Transcobalamin II 776C>G (259P>R) Single Nucleotide Polymorphism by Denaturing HPLC in Healthy Elderly: Associations with Cobalamin, Homocysteine and Holo-Transcobalamin II
- Meetings and Awards
