Influence of homocysteine on final metabolites of oxyde nitrogen in hemodialysis patients

The aim of the study was to determine relations between homocysteine level and indicators of endotelial dysfunctions in patients treated with program hemodialysis. During inspection of 89 program hemodialysis patients concentrations of homocysteine, stable metabolites of oxyde nitrogen and lipidogram indicators were determined. It was found that average homocysteine concentration in hemodialysis patients was higher than in control group (р < 0,001). Concentration of stable metabolites of oxyde nitrogen in surveyed groups was also lower than in practically healthy people; increase in atherogenic lipoproteins in program hemodialysis patients was also revealed. Correlation analysis revealed negative relations between homocysteine concentration and stable metabolites of oxyde nitrogen: nitrates (r = –0,21, р < 0,05), nitrites (r = –0,3, р < 0,01), total metabolites of oxyde nitrogen (r = –0,34, р < 0,05). A positive correlation between homocysteine concentration аnd the total cholesterol (r = 0,28, р < 0,04), low density cholesterol (r = 0,26, р < 0,04), triglycerides (r = 0,22, р = 0,05) were found. Also positive correlation between serum nitrites and the total concentration of stable metabolites of oxyde nitrogen (r = 0,8, р < 0,0001), nitrates (r = 0,4, р < 0,0001) was revealed. Multiple regression analysis revealed a negative relation of concentration of nitrites and homocysteine concentration (b –0,198, р = 0,008) and its direct relation with the total concentration stable metabolites of oxyde nitrogen in blood serum (b = 1,05, р < 0,00001). Conclusions: 1. In hemodialysis patients the levels of homocysteine, atherogenic indicators lipid's spectrum are higher than in practically healthy people. 2. Concentration of final metabolites of oxyde nitrogen in blood serum is in hemodialysis patients authentically lower than in the control group. 3. Statistically significant correlation between concentration of metabolites of oxyde nitrogen and homocysteine level is revealed. 4. Hyperhomocysteinemia can be regarded as an additional marker of endothelial dysfunction in hemodialysis patients.

программный гемодиализ, гомоцистеин, эндотелиальная дисфункция, program hemodialysis, homocysteine, endothelial dysfunction

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