First Division of Nephrology, Department of Cardiothoracic and Respiratory Sciences, Second University of Medicine, via Pansini 5, Naples, Italy.
J Ren Nutr. 2012 Jan;22(1):191-4. doi: 10.1053/j.jrn.2011.10.008.
Chronic renal failure and uremia represent states wherein high blood levels of homocysteine, a cardiovascular risk factor, are largely resistant to folate therapy. Indeed, normalization of homocysteine levels through vitamin administration is rarely achieved in this population, and this fact could explain, among other causes, the negative results of intervention trials designed to lower cardiovascular risk. Dialysis itself lowers homocysteine levels, albeit transitorily. N-acetylcysteine therapy could induce an additional decrease in homocysteine removal during dialysis, thus representing an alternative approach in the attempt to lower cardiovascular risk in these patients.
慢性肾衰竭和尿毒症代表了一种状态，其中同型半胱氨酸（一种心血管风险因素）的血液水平很高，并且对叶酸治疗有很大的抗性。事实上，在该人群中，通过维生素治疗使同型半胱氨酸水平正常化很少能实现，而这一事实可能解释了旨在降低心血管风险的干预试验的负面结果的原因之一。透析本身会降低同型半胱氨酸水平，尽管只是暂时的。N-乙酰半胱氨酸治疗可能会在透析过程中进一步降低同型半胱氨酸的清除率，因此，在试图降低这些患者的心血管风险方面，这是一种替代方法。
