Cardiovascular morbidity and endothelial dysfunction in chronic haemodialysis patients: is homocyst(e)ine the missing link?

Background. Haemodialysis patients exhibit an excessive burden of atherothrombotic disease, which is not explained adequately by traditional risk factors. Hyperhomocyst(e)inaemia, a consistent finding in uraemic patients, is now widely recognized as an independent risk factor for vascular disease. T...

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Veröffentlicht in:Nephrology, dialysis, transplantation dialysis, transplantation, 1999-08, Vol.14 (8), p.1934-1942
Hauptverfasser: Kunz, Kristian, Petitjean, Philippe, Lisri, Mohamed, Chantrel, Frances, Koehl, Christian, Wiesel, Marie-Louise, Cazenave, Jean-Pierre, Moulin, Bruno, Hannedouche, Thierry P.
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Sprache:eng
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Zusammenfassung:Background. Haemodialysis patients exhibit an excessive burden of atherothrombotic disease, which is not explained adequately by traditional risk factors. Hyperhomocyst(e)inaemia, a consistent finding in uraemic patients, is now widely recognized as an independent risk factor for vascular disease. The aim of this study was to examine the hypothesis that hyperhomocyst(e)inaemia is associated with cardiovascular complications in dialysed patients. Methods. In a cohort of 63 stable chronic haemodialysis patients, we examined the causal relationship between hyperhomocyst(e)inaemia and vascular endothelial and haemostatic function. All their markers were determined before and after an 8-week course of a 10 mg per day oral folate supplementation, a manoeuvre known to decrease hyperhomocyst(e)inaemia in uraemic patients. Results. History of at least one cardiovascular atherothrombotic event was present in 47.6% of the haemodialysed patients, and radiographic evidence of vascular calcifications in 70%. Hyperhomocyst(e)inaemia was found in all patients, averaging 3.5-fold the upper limit of normal values (P
ISSN:0931-0509
1460-2385
DOI:10.1093/ndt/14.8.1934