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International Journal of Nephrology
Volume 2010 (2010), Article ID 957645, 4 pages
http://dx.doi.org/10.4061/2010/957645
Research Article

Homocysteine Is a Risk Factor in Predialysis Patients When Associated with Malnutrition and Inflammation

Serviço de Nefrologia, Hospital de Faro, Algarve, Rua Leão Penedo, 8000-342 Faro, Portugal

Received 18 January 2010; Revised 7 April 2010; Accepted 22 April 2010

Academic Editor: Greg Tesch

Copyright © 2010 Ana de Lurdes Agostinho Cabrita Vieira et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The increased level of plasma total homocysteine (tHcy) in chronic kidney disease patients has been reported as a new and independent risk factor for cardiovascular disease. However, after the description of reverse epidemiology in the renal population, the association of tHcy and nutrition became less clear. We evaluated the association between homocysteine, nutritional status, and inflammation, and their impact on mortality in 95 predialysis patients. High sensitivity C-Reactive Protein (hs-CRP), interleukin 6 (IL-6), Tumor Necrosis Factor 𝛼 (TNF- 𝛼 )], and tHcy were evaluated, as was the nutritional status by the modified Subjective Global Nutritional Assessment (mSGA). We divided our population in four groups according to their tHcy and mSGA values being above or below the mean level and found the lowest survival in the group with tHcy and mSGA above the mean level, as well as higher levels of IL-6 ( 𝑃 = . 0 3 ) and TNF- 𝛼 ( 𝑃 = . 0 4 5 ). Higher levels of homocysteine can be associated with higher mortality in predialysis patients, as long as they are associated with malnutrition and inflammation.