Abnormalities of homocysteine and B vitamins in the nephrotic syndrome

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• 作者：Gian Marco Podda ; Federico Lussana ; Gabriella Moroni ; Elena M. Faioni ; Rossana Lombardi ; Gessica Fontana ; Claudio Ponticelli ; Claudio Maioli ; Marco Cattaneo
• 关键词：Nephrotic syndrome ; Homocysteine ; Vitamins ; Thrombosis
• 刊名：Thrombosis Research
• 出版年：2007
• 出版时间：2007
• 年：2007
• 卷：120
• 期：5
• 页码：647-652
• 全文大小：131 K

文摘

The nephrotic syndrome is associated with heightened risk for arterial and venous thrombosis. Multiple derangements of hemostasis and acquired risk factors such as hyperlipidemia and hypertension contribute to this risk. The prevalence in the nephrotic syndrome of high circulating levels of homocysteine and of low levels of the B vitamins that are involved in its metabolism, which may play a role in thrombosis, is not well defined.

Materials and methods

In 84 patients with nephrotic syndrome and 84 sex- and age-matched controls, hemostasis variables and the circulating levels of total homocysteine (tHcy), vitamin B₆, B₁₂ and folates were measured.

Results

tHcy levels were higher, vitamin B₆ and vitamin B₁₂ levels were lower in nephrotic patients than in controls. The association of low vitamin B₆ levels with the nephrotic syndrome was independent of any other alteration associated with the disease. Eighty-two percent of patients with the nephrotic syndrome had vitamin B₆ levels falling in the lowest quartile of the normal distribution. Antithrombin deficiency, factor V Leiden, antiphospholipid antibodies, hypertension, dyslipidemia, were more frequent in patients with the nephrotic syndrome than in controls.

Conclusions

Patients with the nephrotic syndrome have multiple risk factors for thrombosis. We report that they frequently have low circulating levels of vitamin B₆, which associate with a heightened risk for venous and arterial thrombosis.