Hyperhomocysteinemia in renal transplant patients: an independent factor of cardiovascular disease

Hyperhomocysteinemia (Hcy) is an independent factor of cardiovascular disea se, which is the main cause of morbidity and mortality both in uremic and k idney transplant patients. The aim of the study was to determine Hcy, plasm inogen activator inhibitor (PAI-I) and lipoprotein (a) (Lp(a)) serum levels in 70 patients with a well functioning renal transplant. We also verified whether these levels were modified by a multivitamin therapy. The genetic p olymorphism of the methylenetetrahydrofolate reductase (MTHFR) enzyme which plays a main role in Hcy metabolism, was studied as well. We found Hcy, PAI-1 and Lp(a) levels significantly elevated with respect to healthy control subjects. The thermolabile form of the MTHFR enzyme was li nked to higher Hcy levels. After a short time on therapy with B6, B12 and folic acid vitamins, Hcy and PAI-1 decreased to normal levels. The authors conclude that high Hcy levels could be a relevant covariate for cardiovascular disease in transplant patients and they suggest that vitami n supplementation be recommended as a part of therapy.