Hyperhomocysteinemia and progression of renal disease
Finocchiaro, P.; Zoccali, C.
Giornale Italiano di Nefrologia Organo Ufficiale Della Societa Italiana di Nefrologia 22(6): 590-596
2005
ISSN/ISBN: 0393-5590 PMID: 16342051 Document Number: 593822
The relationship between hyperhomocysteinemia and cardiovascular damage is well known, whereas the role of this alteration in renal disease progression has been scarcely studied. Experimental studies demonstrated that exposure to high levels of homocysteinemia causes glomerular and interstitial damage which is remarcably proportional to the serum concentration of this aminoacid. Until now the renal effects of hyperhomocysteinemia in man has been investigated only in observational studies. The Hoorn study, a prospective study in a Dutch population, showed that the plasma homocysteine is a strong predictor of proteinuria in diabetic and non diabetic subjects. Findings in this study were recently confirmed in a cohort study in 7500 Japanese because plasma homocysteine predicted the onset of renal failure in this population. NO-dependent endothelial dysfunction triggered by homocysteine via reduction of the activity of the enzyme that metabolizes Asimmetric Dymethilarginine (dmethylarginine dymethilaminohydrolase) is a likely mechanism whereby hyperomocysteinemia causes cardiovascular and renal damage as well.