Impact of malnutrition-inflammation on the association between homocysteine and mortality.
Kidney Int
; 69(2): 331-5, 2006 Jan.
Article
en En
| MEDLINE
| ID: mdl-16408123
ABSTRACT
Whether high total serum homocysteine levels (tHcy) contribute to increase mortality or offer a survival advantage in chronic hemodialysis patients remains controversial. We conducted a prospective study to determine the impact of tHcy on survival in this population with special respect to chronic inflammation-malnutrition state (CIMS). In this prospective study, 459 hemodialysis patients from 10 dialysis centers located in two regions of France were included. A number of baseline parameters were measured including tHcy and markers of CIMS. Over a mean follow-up period of 54 months, 219 deaths (47.7%) occurred, of which 114 (52%) were of cardiovascular (CV) origin. tHcy of equal to or greater than 30 micromol/l was associated with a higher risk of all-cause mortality in patients without CIMS (hazard ratio (HR) 1.55 (confidence interval (CI) 1.12-4.72)), but not in overall dialysis population or those with CIMS. When only CV mortality was considered, tHcy of equal to or greater than 30 micromol/l was associated with a higher risk in patients without (CIMS HR 1.91 (CI 1.23-3.23)), but not in those with CIMS. Hyperhomocysteinemia is a strong risk factor for all-cause and CV mortality in hemodialysis patients who do not present CIMS. This association might be masked in patients with CIMS.
Buscar en Google
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Diálisis Renal
/
Hiperhomocisteinemia
/
Desnutrición
/
Homocisteína
/
Inflamación
Tipo de estudio:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Aspecto:
Determinantes_sociais_saude
Límite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Kidney Int
Año:
2006
Tipo del documento:
Article
País de afiliación:
Francia