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Evidence for enhanced transsulphuration (TS) as a mechanism underlying lower hyperhomocysteinemia in patients undergoing home nocturnal hemodialysis (HNHD)
Author(s) -
Martincevic Inez,
Goldstein M,
McFarlane P,
House JD,
Pencharz PB,
Pierratos A,
Darling PB
Publication year - 2009
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.23.1_supplement.738.5
Subject(s) - hyperhomocysteinemia , hemodialysis , homocysteine , medicine , dialysis , nocturnal , kidney disease , renal function , endocrinology
Objectives Elevated plasma total homocysteine (tHcy) >12μmol/L, an independent risk factor for cardiovascular disease, is prevalent (>85%) in patients undergoing standard hemodialysis (SHD). The current study was conducted to determine if lower tHcy associated with longer, more frequent dialysis (HNHD) is a function of dialysate HCY losses and/or enhanced HCY metabolism through the TS pathway (cysteine (Cys) and sulphate production). Methods A cross‐sectional study including patients (n=33) on SHD (4 h, 3 days/wk), in‐centre nocturnal hemodialysis (INHD) (6‐8 h, 3 nights/wk) and HNHD (6‐8 h, 5‐7 nights/wk). Blood and dialysate were collected during a mid‐week dialysis session. Conclusions These data suggest that increased dialysate removal of Hcy alone does not explain lower plasma tHcy in HNHD. Rather, increased clearance of sulfate and cysteine may allow increased TS in patients on HNHD. Supported by Kidney Foundation of Canada