Cargando…

Plasma Homocysteine as a Potential Marker of Early Renal Function Decline in IgA Nephropathy

Hyperhomocysteinemia (HHcy) is very common among patients with chronic kidney disease (CKD), and related to the risk of cardiovascular events and mortality in these patients. However, the prevalence of HHcy in primary causes of CKD and its role in kidney disease progression are not well-understood....

Descripción completa

Detalles Bibliográficos
Autores principales: Wang, Yan-Na, Xia, Han, Song, Zhuo-Ran, Zhou, Xu-Jie, Zhang, Hong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8936167/
https://www.ncbi.nlm.nih.gov/pubmed/35321472
http://dx.doi.org/10.3389/fmed.2022.812552
_version_ 1784672167303053312
author Wang, Yan-Na
Xia, Han
Song, Zhuo-Ran
Zhou, Xu-Jie
Zhang, Hong
author_facet Wang, Yan-Na
Xia, Han
Song, Zhuo-Ran
Zhou, Xu-Jie
Zhang, Hong
author_sort Wang, Yan-Na
collection PubMed
description Hyperhomocysteinemia (HHcy) is very common among patients with chronic kidney disease (CKD), and related to the risk of cardiovascular events and mortality in these patients. However, the prevalence of HHcy in primary causes of CKD and its role in kidney disease progression are not well-understood. In this study, we investigated the prevalence of HHcy in different CKD stages in 221 patients with IgA nephropathy (IgAN) and 194 patients with other primary glomerular diseases. We also evaluated the association of homocysteine (Hcy) [after adjusted for estimated glomerular filtration rate (eGFR)] with CKD progression event, defined as ESKD or 50% decline in eGFR, in a cohort of 365 patients with IgAN. The prevalence of HHcy was 67.9% (150/221), 53.5% (76/142), 51.5% (17/33), and 42.1% (8/19) in patients with IgAN, membranous nephropathy, minimal change disease, focal segmental glomerulosclerosis, respectively. The Hcy/eGFR ratio was significantly associated with pathologic features of IgAN, including the proportion of global glomerulosclerosis (r = 0.38, p < 0.001), the proportion of ischemia originated glomerular sclerosis (r = 0.32, p < 0.001), and the severity of tubular atrophy/interstitial fibrosis (r = 0.57, p < 0.001). Importantly, Hcy/eGFR ratio was an independent risk factor for CKD progression event (hazard ratio, 1.38; 95% confidence interval, 1.13–1.68; p = 0.002). The risk of CKD progression events continuously increased with the Hcy/eGFR ratio, but reached a plateau when Hcy/eGFR ratio was >1.79. Our findings suggest that elevated Hcy/eGFR ratio may be an early marker of poor renal outcome in IgAN.
format Online
Article
Text
id pubmed-8936167
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-89361672022-03-22 Plasma Homocysteine as a Potential Marker of Early Renal Function Decline in IgA Nephropathy Wang, Yan-Na Xia, Han Song, Zhuo-Ran Zhou, Xu-Jie Zhang, Hong Front Med (Lausanne) Medicine Hyperhomocysteinemia (HHcy) is very common among patients with chronic kidney disease (CKD), and related to the risk of cardiovascular events and mortality in these patients. However, the prevalence of HHcy in primary causes of CKD and its role in kidney disease progression are not well-understood. In this study, we investigated the prevalence of HHcy in different CKD stages in 221 patients with IgA nephropathy (IgAN) and 194 patients with other primary glomerular diseases. We also evaluated the association of homocysteine (Hcy) [after adjusted for estimated glomerular filtration rate (eGFR)] with CKD progression event, defined as ESKD or 50% decline in eGFR, in a cohort of 365 patients with IgAN. The prevalence of HHcy was 67.9% (150/221), 53.5% (76/142), 51.5% (17/33), and 42.1% (8/19) in patients with IgAN, membranous nephropathy, minimal change disease, focal segmental glomerulosclerosis, respectively. The Hcy/eGFR ratio was significantly associated with pathologic features of IgAN, including the proportion of global glomerulosclerosis (r = 0.38, p < 0.001), the proportion of ischemia originated glomerular sclerosis (r = 0.32, p < 0.001), and the severity of tubular atrophy/interstitial fibrosis (r = 0.57, p < 0.001). Importantly, Hcy/eGFR ratio was an independent risk factor for CKD progression event (hazard ratio, 1.38; 95% confidence interval, 1.13–1.68; p = 0.002). The risk of CKD progression events continuously increased with the Hcy/eGFR ratio, but reached a plateau when Hcy/eGFR ratio was >1.79. Our findings suggest that elevated Hcy/eGFR ratio may be an early marker of poor renal outcome in IgAN. Frontiers Media S.A. 2022-03-07 /pmc/articles/PMC8936167/ /pubmed/35321472 http://dx.doi.org/10.3389/fmed.2022.812552 Text en Copyright © 2022 Wang, Xia, Song, Zhou and Zhang. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Wang, Yan-Na
Xia, Han
Song, Zhuo-Ran
Zhou, Xu-Jie
Zhang, Hong
Plasma Homocysteine as a Potential Marker of Early Renal Function Decline in IgA Nephropathy
title Plasma Homocysteine as a Potential Marker of Early Renal Function Decline in IgA Nephropathy
title_full Plasma Homocysteine as a Potential Marker of Early Renal Function Decline in IgA Nephropathy
title_fullStr Plasma Homocysteine as a Potential Marker of Early Renal Function Decline in IgA Nephropathy
title_full_unstemmed Plasma Homocysteine as a Potential Marker of Early Renal Function Decline in IgA Nephropathy
title_short Plasma Homocysteine as a Potential Marker of Early Renal Function Decline in IgA Nephropathy
title_sort plasma homocysteine as a potential marker of early renal function decline in iga nephropathy
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8936167/
https://www.ncbi.nlm.nih.gov/pubmed/35321472
http://dx.doi.org/10.3389/fmed.2022.812552
work_keys_str_mv AT wangyanna plasmahomocysteineasapotentialmarkerofearlyrenalfunctiondeclineiniganephropathy
AT xiahan plasmahomocysteineasapotentialmarkerofearlyrenalfunctiondeclineiniganephropathy
AT songzhuoran plasmahomocysteineasapotentialmarkerofearlyrenalfunctiondeclineiniganephropathy
AT zhouxujie plasmahomocysteineasapotentialmarkerofearlyrenalfunctiondeclineiniganephropathy
AT zhanghong plasmahomocysteineasapotentialmarkerofearlyrenalfunctiondeclineiniganephropathy