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Impact of Homocysteinemia on Long-Term Renal Transplant Survival
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Authors
Fonseca, Isabel
Martins, La Salete
Advisor(s)
Abstract(s)
Impact of Homocysteinemia on Long-Term Renal Transplant Survival
I. Fonseca, L. Martins, J. Queirós, D. Mendonça, L. Dias, A.M. Sarmento, A.C. Henriques, and A. Cabrita ABSTRACT
Aim. We prospectively followed cohort of 202 renal transplant recipients for years to
examine the impact of fasting homocysteinemia on long-term patient and renal allograft
survival.
Methods. Cox proportional hazards regression analysis was used to identify independent
predictors of all-cause mortality and graft loss.
Results. Hyperhomocysteinemia (tHcy 15 mol/L) was present in 48.7% of the 202
patients, predominantly among men (55.8%as opposed to women (37.1%)At the end of
the follow-up period, 13 (6.4%patients had died including 10 from cardiovascular disease,
and 23 had (11.4%had lost their grafts. Patient death with functioning allograft was the
most prevalent cause of graft loss (13 recipients)Levels of tHcy were higher among
patients who died than among survivors (median 23.9 vs 14.3 mol/L; .005)Median
tHcy concentration was also higher among the patients who had lost their allografts than
those who did not (median 19.0 vs 14.1 mol/L; .001)In Cox regression model
including gender, serum creatinine concentration, transplant duration, traditional cardio-
vascular risk factors, and associated conditions, such as past cardiovascular disease, only
tHcy concentration (ln) (HR 5.50; 95% CI, 1.56 to 19.36; .008) and age at
transplantation (HR 1.07; 95% CI, 1.02 to 1.13; .01) were independent predictors
of patient survival. After censoring data for patient death, tHcy concentration was not
risk factor for graft loss.
Conclusions. This prospective study shows that tHcy concentration is significant
predictor of mortality, but not of graft loss, after censoring data for patient death.
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Publisher
Transplantation Proceedings