Association between plasma homocysteine concentrations and cardiac hypertrophy in end-stage renal disease

In patients with end-stage renal disease, plasma homocysteine and cardiac mass are both increased and considered independent risk predictors for cardiovascular-specific morbidity and mortality. In order to establish a relationship between these two parameters, we determined cardiac mass and plasma homocysteine in 75 patients with end-stage renal disease undergoing chronic hemodialysis. We observed a statistically significant positive association between plasma homocysteine and cardiac mass index or either of its components. This was observed even after adjustment for age, sex, systolic blood pressure and hematocrit (p = 0.0027). The adjusted odds ratio for left ventricular hypertrophy was 6.6 (95 % confidence interval 1.3-32.8) for subjects with the highest versus the lowest plasma homocysteine concentrations. This cross-sectional study is the first to show a statistical link between plasma homocysteine and cardiac structure, independently of mechanical factors. High plasma homocysteine concentrations are associated with an increased adjusted risk of left ventricular hypertrophy in end-stage renal disease patients.