Suliman ME, Qureshi AR, Anderstam B, Gutierrez A, Lindholm B, Bergstrom J
Nutritional status and plasms total homocysteine in hemodialysis patients
23rd ESAO Congress, Warsaw
Int J Artif Organs (Sep) 10:507 1996

It is now recognized that plasma homocysteine levels, which are known to increase risk of atherosclerosis and thrombosis in non-dialysis patients, are quite elevated in ESRD. In this abstract, Bergstrom's group studied plasma homocysteine and cysteine levels in 117 HD patients who were also evaluated re their nutritional status (65/117 were found to be malnourished).

The HD patients all had about 3-fold elevations of their homocysteine levels. Interestingly, plasma homocysteine levels were lower (mean 24 uM) in malnourished HD patients than in well nourished HD patients (mean 31 uM, normal controls 9 uM). The malnourished HD patients had a higher incidence of cardiovascular diseases despite their lower plasma homocysteine levels.

Comment: The interesting result of this study was, that in HD patients high plasma homocysteine levels did not predict cardiovascular disease, and that cardiovascular disease appeared to occur more commonly in malnourished patients. This is similar to observations made by Foley et al at last year's ASN (1995). Thus, nutritional status and plasma homocysteine levels appear to be correlated in ESRD, but to have opposite effects on cardiovascular disease. (John T. Daugirdas, M.D., University of Illinois at Chicago)

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23rd ESAO Congress, Warsaw
CRF by organ system : Nutrition
CRF by organ system : Cardiovascular/Hypertension