Hyperhomocysteinemia predicts cardiovascular outcomes in hemodialysis patients

Francesca Mallamaci, Carmine Zoccali, Giovanni Tripepi, Isabella Fermo, Francesco A. Benedetto, Alessandro Cataliotti, Ignazio Bellanuova, Lorenzo Salvatore Malatino, Armando Soldarini

Research output: Contribution to journalArticle

254 Citations (Scopus)

Abstract

Background. We prospectively tested the prediction power of homocysteinemia for all-cause and cardiovascular outcomes in a cohort of 175 hemodialysis patients followed for 29 ± 12 months. Methods. Survival analysis was performed by the Cox's proportional hazard model and data were expressed as hazard ratio and 95% confidence interval (CI). Results. During the follow-up period 51 patients died, 31 of them (61%) of cardiovascular causes and 16 patients developed non-fatal atherothrombotic complications. Plasma total homocysteine was an independent predictor of cardiovascular mortality (P = 0.01). Combined analysis of fatal and non-fatal atherothrombotic events showed that homocysteine was a strong and independent predictor of these outcomes because the risk of these events was 8.2 times higher (95% CI 1.9 to 32.2) in patients in the third homocysteine tertile than in those in the first tertile (P = 0.005). Conclusions. There is a clear association between hyperhomocysteinemia and incident cardiovascular mortality and atherothrombotic events in hemodialysis patients. Intervention studies are needed to determine whether the accumulation of this substance has a causal role in the pathogenesis of cardiovascular damage in patients undergoing hemodialysis.

Original languageEnglish (US)
Pages (from-to)609-614
Number of pages6
JournalKidney International
Volume61
Issue number2
DOIs
StatePublished - 2002
Externally publishedYes

Fingerprint

Hyperhomocysteinemia
Renal Dialysis
Homocysteine
Confidence Intervals
Mortality
Survival Analysis
Proportional Hazards Models

Keywords

  • Arteriovenous disease
  • Blood pressure
  • Cardiovascular risk
  • Dialysis
  • Homocysteine
  • Mortality study
  • Thrombosis

ASJC Scopus subject areas

  • Nephrology

Cite this

Mallamaci, F., Zoccali, C., Tripepi, G., Fermo, I., Benedetto, F. A., Cataliotti, A., ... Soldarini, A. (2002). Hyperhomocysteinemia predicts cardiovascular outcomes in hemodialysis patients. Kidney International, 61(2), 609-614. https://doi.org/10.1046/j.1523-1755.2002.00144.x

Hyperhomocysteinemia predicts cardiovascular outcomes in hemodialysis patients. / Mallamaci, Francesca; Zoccali, Carmine; Tripepi, Giovanni; Fermo, Isabella; Benedetto, Francesco A.; Cataliotti, Alessandro; Bellanuova, Ignazio; Malatino, Lorenzo Salvatore; Soldarini, Armando.

In: Kidney International, Vol. 61, No. 2, 2002, p. 609-614.

Research output: Contribution to journalArticle

Mallamaci, F, Zoccali, C, Tripepi, G, Fermo, I, Benedetto, FA, Cataliotti, A, Bellanuova, I, Malatino, LS & Soldarini, A 2002, 'Hyperhomocysteinemia predicts cardiovascular outcomes in hemodialysis patients', Kidney International, vol. 61, no. 2, pp. 609-614. https://doi.org/10.1046/j.1523-1755.2002.00144.x
Mallamaci F, Zoccali C, Tripepi G, Fermo I, Benedetto FA, Cataliotti A et al. Hyperhomocysteinemia predicts cardiovascular outcomes in hemodialysis patients. Kidney International. 2002;61(2):609-614. https://doi.org/10.1046/j.1523-1755.2002.00144.x
Mallamaci, Francesca ; Zoccali, Carmine ; Tripepi, Giovanni ; Fermo, Isabella ; Benedetto, Francesco A. ; Cataliotti, Alessandro ; Bellanuova, Ignazio ; Malatino, Lorenzo Salvatore ; Soldarini, Armando. / Hyperhomocysteinemia predicts cardiovascular outcomes in hemodialysis patients. In: Kidney International. 2002 ; Vol. 61, No. 2. pp. 609-614.
@article{009111ae74b54af2853602eb7b84a3b8,
title = "Hyperhomocysteinemia predicts cardiovascular outcomes in hemodialysis patients",
abstract = "Background. We prospectively tested the prediction power of homocysteinemia for all-cause and cardiovascular outcomes in a cohort of 175 hemodialysis patients followed for 29 ± 12 months. Methods. Survival analysis was performed by the Cox's proportional hazard model and data were expressed as hazard ratio and 95{\%} confidence interval (CI). Results. During the follow-up period 51 patients died, 31 of them (61{\%}) of cardiovascular causes and 16 patients developed non-fatal atherothrombotic complications. Plasma total homocysteine was an independent predictor of cardiovascular mortality (P = 0.01). Combined analysis of fatal and non-fatal atherothrombotic events showed that homocysteine was a strong and independent predictor of these outcomes because the risk of these events was 8.2 times higher (95{\%} CI 1.9 to 32.2) in patients in the third homocysteine tertile than in those in the first tertile (P = 0.005). Conclusions. There is a clear association between hyperhomocysteinemia and incident cardiovascular mortality and atherothrombotic events in hemodialysis patients. Intervention studies are needed to determine whether the accumulation of this substance has a causal role in the pathogenesis of cardiovascular damage in patients undergoing hemodialysis.",
keywords = "Arteriovenous disease, Blood pressure, Cardiovascular risk, Dialysis, Homocysteine, Mortality study, Thrombosis",
author = "Francesca Mallamaci and Carmine Zoccali and Giovanni Tripepi and Isabella Fermo and Benedetto, {Francesco A.} and Alessandro Cataliotti and Ignazio Bellanuova and Malatino, {Lorenzo Salvatore} and Armando Soldarini",
year = "2002",
doi = "10.1046/j.1523-1755.2002.00144.x",
language = "English (US)",
volume = "61",
pages = "609--614",
journal = "Kidney International",
issn = "0085-2538",
publisher = "Nature Publishing Group",
number = "2",

}

TY - JOUR

T1 - Hyperhomocysteinemia predicts cardiovascular outcomes in hemodialysis patients

AU - Mallamaci, Francesca

AU - Zoccali, Carmine

AU - Tripepi, Giovanni

AU - Fermo, Isabella

AU - Benedetto, Francesco A.

AU - Cataliotti, Alessandro

AU - Bellanuova, Ignazio

AU - Malatino, Lorenzo Salvatore

AU - Soldarini, Armando

PY - 2002

Y1 - 2002

N2 - Background. We prospectively tested the prediction power of homocysteinemia for all-cause and cardiovascular outcomes in a cohort of 175 hemodialysis patients followed for 29 ± 12 months. Methods. Survival analysis was performed by the Cox's proportional hazard model and data were expressed as hazard ratio and 95% confidence interval (CI). Results. During the follow-up period 51 patients died, 31 of them (61%) of cardiovascular causes and 16 patients developed non-fatal atherothrombotic complications. Plasma total homocysteine was an independent predictor of cardiovascular mortality (P = 0.01). Combined analysis of fatal and non-fatal atherothrombotic events showed that homocysteine was a strong and independent predictor of these outcomes because the risk of these events was 8.2 times higher (95% CI 1.9 to 32.2) in patients in the third homocysteine tertile than in those in the first tertile (P = 0.005). Conclusions. There is a clear association between hyperhomocysteinemia and incident cardiovascular mortality and atherothrombotic events in hemodialysis patients. Intervention studies are needed to determine whether the accumulation of this substance has a causal role in the pathogenesis of cardiovascular damage in patients undergoing hemodialysis.

AB - Background. We prospectively tested the prediction power of homocysteinemia for all-cause and cardiovascular outcomes in a cohort of 175 hemodialysis patients followed for 29 ± 12 months. Methods. Survival analysis was performed by the Cox's proportional hazard model and data were expressed as hazard ratio and 95% confidence interval (CI). Results. During the follow-up period 51 patients died, 31 of them (61%) of cardiovascular causes and 16 patients developed non-fatal atherothrombotic complications. Plasma total homocysteine was an independent predictor of cardiovascular mortality (P = 0.01). Combined analysis of fatal and non-fatal atherothrombotic events showed that homocysteine was a strong and independent predictor of these outcomes because the risk of these events was 8.2 times higher (95% CI 1.9 to 32.2) in patients in the third homocysteine tertile than in those in the first tertile (P = 0.005). Conclusions. There is a clear association between hyperhomocysteinemia and incident cardiovascular mortality and atherothrombotic events in hemodialysis patients. Intervention studies are needed to determine whether the accumulation of this substance has a causal role in the pathogenesis of cardiovascular damage in patients undergoing hemodialysis.

KW - Arteriovenous disease

KW - Blood pressure

KW - Cardiovascular risk

KW - Dialysis

KW - Homocysteine

KW - Mortality study

KW - Thrombosis

UR - http://www.scopus.com/inward/record.url?scp=0036153990&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0036153990&partnerID=8YFLogxK

U2 - 10.1046/j.1523-1755.2002.00144.x

DO - 10.1046/j.1523-1755.2002.00144.x

M3 - Article

C2 - 11849403

AN - SCOPUS:0036153990

VL - 61

SP - 609

EP - 614

JO - Kidney International

JF - Kidney International

SN - 0085-2538

IS - 2

ER -