Plasma Homocysteine Concentration in Hemodialysis Patients of Kerman/Iran in 2005

Introduction: Homocysteine is an aminoacid yielded from methionin to cysteine metabolism. Normal plasma concentration of homocysteine in human is between 5-15 mol/l and an increase more than 5 mol/l can increase the risk of cardiovascular diseases, atherosclerosis and thrombosis. On the other hand in dialysis patients due to some reasons such as uremia, genetic factors, dialysis related factors and vitamin B group deficiency, the plasma level of homocysteine increases. This study was done to evaluate Plasma vitamin B12, Folic acid and homocysteine levels in kerman hemodialysis patients in comparison to healthy persons. Methods: In this cross-sectional study performed in two hemodialysis units of kerman-Iran, 25 hemodialysis patients and 25 healthy persons were studied. Blood samples were drawn prior to the dialysis session. The samples were centrifuged and the plasma was kept frozen at -20° C until analysis. Homocysteine level was determined by Gas-Chromatography and vitamin levels analysis were determined by radio assay method. Results: Mean homocysteine level in hemodialysis patients (19.7±8.8 mol/l) showed significant difference (P=0.024) with healthy persons, homocysteine level (15.3±3 mol/l). There were no relationship between the time passed since the first dialysis (p=0.188) and patients, age (p=0.419) with homocysteine levels. Plasma vitmin B12 and folic acid levels in hemodialysis patients were 4672±2379 pg/ml and 47±17 ng/ml respectively. These values were much more than those in healthy persons (959±409 Pmol/L and 14±12nmol/L respectively). Conclusion: Although homocysteine level in our patients was more than healthy persons, but it was lower than that of hemodialysis patients in other countries. This difference may be related to some factors such as genetic factors and administration of daily oral folic acid and Intravenous injection of B12 and B Complex after each dialysis session. Therefore this procedure is recommended in hemodialysis patients.