Prevalence of Homocysteine‐Related Hypertension in Patients With Chronic Kidney Disease

Ye, Zengchun; Wang, Cheng; Zhang, Qunzi; Yan, Li; Zhang, Jun; Ma, Xinxin; Peng, Hui; Lou, Tanqi

doi:10.1111/jch.12881

Cited by 34 publications

(34 citation statements)

References 32 publications

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“…Similar to homocystinuria patients, in CKD patients, aged and well-nourished population substantial evidences of hyperhomocysteinemia is established [127-129]. It is still not conclusive whether hyperhomocysteinemia causes hypertension in these patients [130, 131]. …”

Section: Involvement Of Thiol Homocysteine and H2s In Renovascularmentioning

confidence: 99%

Homocysteine and hydrogen sulfide in epigenetic, metabolic and microbiota related renovascular hypertension

Weber

Pushpakumar

Tyagi

et al. 2016

Pharmacological Research

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Over the past several years, hydrogen sulfide (H2S) has been shown to be an important player in a variety of physiological functions, including neuromodulation, vasodilation, oxidant regulation, inflammation, and angiogenesis. H2S is synthesized primarily through metabolic processes from the amino acid cysteine and homocysteine in various organ systems including neuronal, cardiovascular, gastrointestinal, and kidney. Derangement of cysteine and homocysteine metabolism and clearance, particularly in the renal vasculature, leads to H2S biosynthesis deregulation causing or contributing to existing high blood pressure. While a variety of environmental influences, such as diet can have an effect on H2S regulation and function, genetic factors, and more recently epigenetics, also have a vital role in H2S regulation and function, and therefore disease initiation and progression. In addition, new research into the role of gut microbiota in the development of hypertension has highlighted the need to further explore these microorganisms and how they influence the levels of H2S throughout the body and possibly exploiting microbiota for use of hypertension treatment. In this review, we summarize recent advances in the field of hypertension research emphasizing renal contribution and how H2S physiology can be exploited as a possible therapeutic strategy to ameliorate kidney dysfunction as well as to control blood pressure.

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Section: Involvement Of Thiol Homocysteine and H2s In Renovascularmentioning

confidence: 99%

Homocysteine and hydrogen sulfide in epigenetic, metabolic and microbiota related renovascular hypertension

Weber

Pushpakumar

Tyagi

et al. 2016

Pharmacological Research

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show abstract

“…Hyperhomocysteinemia might cause renal damage through these mechanisms. Conversely, renal dysfunction elevates homocysteine concentration, probably due to decreasing renal metabolic extraction [15]. Thus, there exist bidirectional, functional relationships between hyperhomocysteinemia and decreased renal function.…”

Section: Discussionmentioning

confidence: 99%

“…This is supported by our finding that homocysteine level was higher in patients with hypertension and that it did not correlate with blood pressure values measured during hospitalization. Hyperglycemia, high blood pressure, and hyperhomocysteinemia [15,26,27] all accelerate atherosclerosis. Thus, we must assume that subjects with hyperhomocysteinemia have a long history of diabetes or hypertension and very high risk for atherosclerotic diseases.…”

Section: Discussionmentioning

confidence: 99%

“…For example, chronic inflammation [9], oxidative stress [10], advanced glycation end-products [11], homocysteine [12], and uric acid [13] are such risk factors. Serum homocysteine level is increased in patients with CKD [14][15][16]. However, there are conflicting reports that the homocysteine level is increased [17] or decreased [18] in diabetic patients.…”

Section: Introductionmentioning

confidence: 99%

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Hyperhomocysteinemia and Hyperuricemia are Closely Associated with a Decline in Renal Function in Patients with Type 2 Diabetes

Tanaka¹,

Nishimura²,

Itoh³

2017

J Diabetes Metab

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Objective: This study examined the association of homocysteine and uric acid with estimated glomerular filtration rate (eGFR) and explored their pathophysiological significance in patients with type 2 diabetes mellitus. Methods:We performed a cross-sectional study in 56 Japanese patients with type 2 diabetes. The correlations of serum total homocysteine level with age, diabetes duration, HbA1c, body mass index, systolic blood pressure, eGFR, urinary albumin-to-creatine ratio (ACR), and uric acid were investigated. The correlation between eGFR and uric acid was also investigated. Serum total homocysteine level was compared in men and women, as well as in patients with and without diabetic nephropathy, hypertension, smoking, and alcohol consumption. Stepwise multiple regression analyses were performed to identify explanatory factors for eGFR, total homocysteine, and uric acid. Results:Serum total homocysteine level showed a significant positive correlation with diabetes duration, ACR, and uric acid, and an inverse correlation with eGFR. Uric acid level and eGFR showed a significant inverse correlation. Patients with diabetic nephropathy and hypertension showed a significantly higher total homocysteine level. Multiple regression analyses demonstrated that age, total homocysteine, and uric acid were independent determinants of eGFR, and that age and eGFR were independent determinants of both total homocysteine and uric acid levels. Conclusion:Although total homocysteine, uric acid, and eGFR showed correlations, the relationship between uric acid and homocysteine might be weaker than that between eGFR and homocysteine, and between eGFR and uric acid. A relatively weak association between hyperuricemia and hyperhomocysteinemia observed in our study suggests confounding by decreased renal function. Both total homocysteine and uric acid can be used as biomarkers of renal dysfunction in patients with type 2 diabetes.

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“…Li et al demonstrated that the concentration of Hcy is independently associated with the occurrence of early diabetic nephropathy in Chinese patients [8]. In addition, Ye et al found that the prevalence of both hypertension and HHcy was high and associated with target organ damage in patients with CKD [9]. Moreover, Eun-Hee Cho et al carried out a nested case-control study in patients with type 2 diabetes and found that HHcy was associated with an increased risk of MAU [10].…”

Section: Introductionmentioning

confidence: 99%

Association Between Plasma Homocysteine and Microalbuminuria in Untreated Patients with Essential Hypertension: a Case-Control Study

Kuang

Wang

Feng

et al. 2017

Kidney Blood Press Res

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Background/Aims: Kidney function is critical for homocysteine (Hcy) clearance, and plasma Hcy levels are frequently increased in patients with renal failure. Microalbuminuria (MAU) is an important marker of early renal damage caused by hypertension. At present, there is insufficient evidence on the relationship between Hcy and microalbuminuria. Methods: This is a 1: 2 matched, hospital-based case-control study. At initial visit, out of 1535 outpatients with no prior history of medication, 450 qualified subjects were selected based on inclusion and exclusion criteria. The concentration of Hcy in the serum was evaluated using a cyclic enzyme method. MAU was defined by a urine albumin/creatinine ratio (UACR) between 30 μg/mg and 300 μg/mg. Results: A total of 450 patients were included in this study (150 in the MAU group and 300 in the non-MAU group). The MAU group had higher mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP), heart rate (HR) and plasma Hcy levels than did the non-MAU group. The area under the receiver operating characteristics (ROC) curves was 0.772 (95% CI: 0.724–0.819, P < 0.001) with a cut-off value of 15.0, and the sensitivity and specificity of Hcy in predicting the MAU status in hypertensive patients were 49.3% and 92.3%, respectively. Multiple logistic regression modelling suggested that patients with a higher Hcy level (> 15 µmol/L) were more likely to have MAU (95% CI: 5.650–16.543, P < 0.001). The other predictive factor for MAU was 24-h mean SBP (95% CI: 0.941–0.993, P = 0.015). Conclusion: This matched case-control study indicates that Hcy may increase the susceptibility of essential hypertensive subjects to MAU.

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Prevalence of Homocysteine‐Related Hypertension in Patients With Chronic Kidney Disease

Cited by 34 publications

References 32 publications

Homocysteine and hydrogen sulfide in epigenetic, metabolic and microbiota related renovascular hypertension

Homocysteine and hydrogen sulfide in epigenetic, metabolic and microbiota related renovascular hypertension

Hyperhomocysteinemia and Hyperuricemia are Closely Associated with a Decline in Renal Function in Patients with Type 2 Diabetes

Association Between Plasma Homocysteine and Microalbuminuria in Untreated Patients with Essential Hypertension: a Case-Control Study

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