Homocystein concentration and selected indicators of atherosclerosis development, considering long term morbidity and mortality in hemodialysis patients
homocysteine ; atherosclerosis ; hemodialysis ; mortality ; morbidity
Cardio-vascular diseases are the most common causes of death and hospitalization among hemodialyzed patients. Until now high levels of serum homocystein in these patients was considered as an independent atherosclerotic factor. Study aim was to observe homocystein levels in hemodialysis patients depending on folic acid supplementation, long-term treatment with rHuEPO and folic acid and their influence on selected indicators of atherosclerotic development; as well as influence of increased homocystein levels in the study group on morality and morbidity during the period of folic acid supplementation and after 8 years. The study included 100 patients (48 males and 52 females) between 21 and 80 years with end stage renal failure treated by hemodialysis during a period from 2 to 278 months. After study correlation analysis of generating factors of atherosclerosis, it was found that folic acid supplementation significantly influenced decrease of serum homocystein level in these patients. Decrease of homocystein level positively correlated with the supplementation dosage of folic acid and its serum concentration. Among atherosclerotic generating factors, long-term treatment with rHuEPO and folic acid supplementation contributed to decease in pro-atherosclerotic lipoprotein A [Lp(a)]. Serum homocystein level in hemodialyzed patients remains without influence on morbidity and mortalit ; y in this adult population.
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nefrologia ; choroby układu krążenia