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Impact of homocysteinemia on long-term renal transplant survival.

Abstract：

AIM:We prospectively followed a cohort of 202 renal transplant recipients for 5 years to examine the impact of fasting homocysteinemia on long-term patient and renal allograft survival. METHODS:Cox proportional hazards regression analysis was used to identify independent predictors of all-cause mortality and graft loss. RESULTS:Hyperhomocysteinemia (tHcy >15 micromol/L) was present in 48.7% of the 202 patients, predominantly among men (55.8%) as opposed to women (37.1%). At the end of the follow-up period, 13 (6.4%) patients had died including 10 from cardiovascular disease, and 23 had (11.4%) had lost their grafts. Patient death with a functioning allograft was the most prevalent cause of graft loss (13 recipients). Levels of tHcy were higher among patients who died than among survivors (median 23.9 vs 14.3 micromol/L; P = .005). Median tHcy concentration was also higher among the patients who had lost their allografts than those who did not (median 19.0 vs 14.1 micromol/L; P = .001). In a Cox regression model including gender, serum creatinine concentration, transplant duration, traditional cardiovascular risk factors, and associated conditions, such as past cardiovascular disease, only tHcy concentration (ln) (HR = 5.50; 95% CI, 1.56 to 19.36; P = .008) and age at transplantation (HR = 1.07; 95% CI, 1.02 to 1.13; P = .01) were independent predictors of patient survival. After censoring data for patient death, tHcy concentration was not a risk factor for graft loss. CONCLUSIONS:This prospective study shows that tHcy concentration is a significant predictor of mortality, but not of graft loss, after censoring data for patient death.

journal_name

Transplant Proc

journal_title

Transplantation proceedings

authors

Fonseca I,Martins L,Queirós J,Mendonça D,Dias L,Sarmento AM,Henriques AC,Cabrita A

doi

10.1016/j.transproceed.2005.05.041

subject

Has Abstract

pub_date

2005-07-01 00:00:00

pages

2784-8

issue

6

eissn

0041-1345

issn

1873-2623

pii

S0041-1345(05)00609-3

journal_volume

37

pub_type

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