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Plasma homocysteine and folate levels and dietary folate intake in adolescents and young adults who underwent kidney transplantation during childhood

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Abstract

Background

Hyperhomocysteinemia (hyper-Hcy) is an important and reversible cardiovascular disease risk factor. We examined the prevalence of hyper-Hcy, plasma folate levels, and dietary folate intake in adolescents and young adults who had undergone kidney transplantation during childhood to assess the necessity for managing dietary folate.

Methods

This cross-sectional study was performed in 89 kidney transplant recipients (age at kidney transplantation: 12.6 ± 4.1 years; age during study: 21.2 ± 5.5 years). Hyper-Hcy and plasma folate deficiency were defined as plasma homocysteine (Hcy) >15 nmol/ml and plasma folate <3.0 ng/ml, respectively.

Results

Of the patients, 60 (67.4 %) had hyper-Hcy and 14 (15.7 %) had plasma folate deficiency. Plasma homocysteine levels correlated negatively with estimated glomerular filtration rate (eGFR; r = −0.565, p < 0.01) and plasma folate levels (r = −0.434, p < 0.01). For determinants of plasma homocysteine levels, a priori selected variables included kind of calcineurin inhibitor, age at kidney transplantation, pretransplant duration of dialysis, time since transplantation, age at examination, eGFR, and plasma folate. Stepwise multiple linear regression analysis revealed eGFR and plasma folate levels as significant independent variables influencing plasma homocysteine levels. Dietary folate intake in 11 of 16 patients (66.8 %) with eGFR ≥60 ml/min/1.73 m2 was below the recommended dietary allowance for Japanese.

Conclusions

The prevalence of hyper-Hcy and plasma folate deficiency, as well as the low dietary folate intake, suggest that dietary management of folate is necessary for adolescents and young adults who have undergone kidney transplantation during childhood.

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Acknowledgments

The authors gratefully acknowledge Drs. Noriko Sugawara and Kiyonobu Ishizuka (Department of Pediatric Nephrology, Tokyo Women’s Medical University, School of Medicine, Japan) for their research assistance.

Conflict of interest

The authors have declared that no conflict of interest exists.

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Authors and Affiliations

  1. Department of Pediatric Nephrology, School of Medicine, Tokyo Women’s Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan

    Ryoko Hamatani, Miki Otsu, Hiroko Chikamoto, Yuko Akioka & Motoshi Hattori

  2. Department of Human Sciences, Tokiwa University, 1-430-1 Miwa, Mito, Ibaraki, 310-8585, Japan

    Miki Otsu

  3. Research Student (National Registered Dietitian), School of Medicine, Tokyo Women’s Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan

    Ryoko Hamatani & Miki Otsu

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  1. Ryoko Hamatani
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  2. Miki Otsu
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Correspondence to Motoshi Hattori.

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Hamatani, R., Otsu, M., Chikamoto, H. et al. Plasma homocysteine and folate levels and dietary folate intake in adolescents and young adults who underwent kidney transplantation during childhood. Clin Exp Nephrol 18, 151–156 (2014). https://doi.org/10.1007/s10157-013-0819-3

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  • DOI: https://doi.org/10.1007/s10157-013-0819-3

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