The relationship between serum homocysteine and highly sensitive C- reactive protein levels in children on regular hemodialysis

Abstract

Hyperhomocysteinemia has attracted a lot of attention in renal patients, not only because of its close relationship with renal function but also because it has been implicated as an independent cardiovascular risk factor in these patients. An increased level of C-reactive protein (CRP) has been reported to be a strong predictor of cardiovascular mortality in hemodialysis (HD) patients. The aim of this study was to assess the association between homocysteine (Hcy) and highly sensitive CRP (hsCRP) in cardiovascular risk prediction in children with chronic kidney disease (CKD) on HD. This case-control study was conducted on 40 children with CKD on regular HD and 20 age- and sex-matched healthy children as controls. Their ages ranged from 4 to 18 years, and they were selected from the pediatric nephrology and HD unit at Al-Azhar University Hospital, during the period from May 2015 to April 2016. Complete blood count, serum ferritin, cholesterol, triglycerides, calcium, phosphorus, parathormone (PTH), Hcy, and hsCRP levels were measured in both groups. Measurements of anthropometry and blood pressure (BP) were performed. There was a significant increase in serum Hcy levels in cases than controls; it was 17.22 ± 9.66 pmol/L and 6.32 ± 1.47 pmol/L, respectively (P <0.01). Furthermore, there was a significant increase in hsCRP in patients than controls; 2.73 ± 2.65 and 0.9 ± 0.85, respectively (P <0.01). There was a significant positive correlation between hsCRP and Hcy with BP, cholesterol, triglyceride, PTH, and ferritin levels. Our data highlighted the important correlation between serum Hcy and hsCRP to detect high-risk patients for subsequent cardiovascular disease and utility of preventive strategies that attenuate inflammatory risk.