An Insight to Hyperhomocysteinaemia in CKD Patients of a Tertiary Care Hospital, Karachi.

Abstract

Objective: To evaluate the frequency and association of hyperhomocysteinaemia (HHcy) in different stages of chronic kidney disease (CKD) patients.

Study design: Cross-sectional, descriptive study. Place and Duration of the Study: Department of Chemical Pathology, Indus Hospital and Health Network Karachi, Pakistan, from July to December 2022.

Methodology: Blood samples of 100 known CKD patients were collected for this study. The estimated glomerular filtration rate (eGFR) was calculated from the CKD-EPI calculator for CKD staging. Plasma homocysteine (Hcy) and serum creatinine concentrations were analysed on Abbott Alinity I and C analyzers, respectively. The SPSS was used for data compilation and analysis. Descriptive statistics were calculated. The association of HHcy with CKD and other variables was assessed using the Chi-square test as appropriate. A p-value of ≤0.05 was considered as significant.

Results: Out of total 100, 52% males and 48% females known CKD patients were included in the study. The mean age of the patients was 50.62 ± 16.29 years. The median eGFR, serum creatinine, and Homocysteine were 18 ml/min/1.73m2, 3.48mg/dl, and 20.07 μmol/l, respectively. The percentage of CKD patients in each stage was 7% in stage 3a, 18% in stage 3b, 30% in stage 4, and 45% in stage 5. HHcy was observed in 79% of the CKD patients and among them 7.6% patients were in stage 3a, 19.0% in stage 3b, 31.6% in stage 4, and 41.8 % in stage 5.

Conclusion: Patients with CKD were found to have HHcy indicating a very high level of prevalence in CKD patients, especially in the late stages. Hence, Hcy can be considered as a predictor of advancing disease. Timely interventions are required to prevent future adverse outcomes and improve the quality of life in CKD patients. However, a significant association was not seen between Hcy concentration and eGFR stages in the current study.

Key words: Hyperhomocysteinaemia, Estimated glomerular filtration rate, CKD-EPI calculator, Mortality, End-stage renal disease, Cardiovascular disease.