Serum total homocysteine concentration does not predict outcome in renal transplant recipients

Established cardiovascular risk factors such as hypercholesterolemia have b een claimed to adversely influence the outcome of renal transplants. The ai m of the present study was to assess the effect of another risk factor, hyp erhomocysteinemia, on graft outcome. This was relevant for two reasons; hyp erhomocysteinemia is by now recognized as an independent risk factor for th e development of atherosclerosis and it is highly prevalent in both dialysi s patients and renal transplant recipients. The serum concentration of tota l homocysteine (tHcy) was analyzed in samples collected before transplantat ion in 81 patients and at 6 months after transplantation in 57 of these pat ients. Before transplantation, mean tHcy was 33.2 +/- 19.2 mu moI/L and the prevalence of hyperhomocysteinemia was 94%. Six months after transplantati on, mean tHcy was 27.7 +/- 14.6 mu mol/L and the prevalence of hyperhomocys teinemia was 88%. The patients were followed up for 5 yr. Six months and 5 yr after transplantation, serum creatinine concentration and endogenous cre atinine clearance were determined. After 6 months, allograft biopsy was eva luated. Neither pre- nor post-transplant tHcy was found to influence patien t or graft survival, graft function or histopathology. Thus, tHcy does not seem to predict either short-term or long-term outcome of renal transplanta tion.