Amin Hatem K, El-Sayed Mohamed-I Kotb, Leheta Ola F
a Department of Biochemistry and Molecular Biology, Faculty of Pharmacy , Helwan University , Cairo , Egypt ;
b Cell Cycle Control Group, Center for Chromosome Biology , National University of Ireland , Galway , Ireland ;
Ren Fail. 2016 Sep;38(8):1267-75. doi: 10.1080/0886022X.2016.1209382. Epub 2016 Jul 19.
Glomerular filtration rate and/or creatinine are not accurate methods for renal failure prediction. This study tested homocysteine (Hcy) as a predictive and prognostic marker for end stage renal disease (ESRD). In total, 176 subjects were recruited and divided into: healthy normal group (108 subjects); mild-to-moderate impaired renal function group (21 patients); severe impaired renal function group (7 patients); and chronic renal failure group (40 patients) who were on regular hemodialysis. Blood samples were collected, and serum was separated for analysis of total Hcy, creatinine, high sensitive C-reactive protein (CRP), serum albumin, and calcium. Data showed that Hcy level was significantly increased from normal-to-mild impairment then significantly decreases from mild impairment until the patient reaches severe impairment while showing significant elevation in the last stage of chronic renal disease. Creatinine level was increased in all stages of kidney impairment in comparison with control. CRP level was showing significant elevation in the last stage. A significant decrease in both albumin and calcium was occurred in all stages of renal impairment. We conclude Hcy in combination with CRP, creatinine, albumin, and calcium can be used as a prognostic marker for ESRD and an early diagnostic marker for the risk of renal failure.
肾小球滤过率和/或肌酐并非预测肾衰竭的准确方法。本研究检测了同型半胱氨酸（Hcy）作为终末期肾病（ESRD）的预测和预后标志物。总共招募了176名受试者，并将其分为：健康正常组（108名受试者）；轻度至中度肾功能受损组（21名患者）；重度肾功能受损组（7名患者）；以及接受定期血液透析的慢性肾衰竭组（40名患者）。采集血样，分离血清以分析总Hcy、肌酐、高敏C反应蛋白（CRP）、血清白蛋白和钙。数据显示，Hcy水平从正常到轻度受损显著升高，然后从轻度受损到重度受损显著下降，而在慢性肾病的最后阶段显著升高。与对照组相比，肌酐水平在肾脏损伤的所有阶段均升高。CRP水平在最后阶段显著升高。在肾功能损害的所有阶段，白蛋白和钙均显著降低。我们得出结论，Hcy与CRP、肌酐、白蛋白和钙联合使用可作为ESRD的预后标志物和肾衰竭风险的早期诊断标志物。
