S-adenosylhomocysteine is a more sensitive indicator of renal insufficiency than homocysteine

Patients with decreased renal function have a very high incidence of cardiac disease and stroke and have very high levels of plasma homocysteine. We have shown that plasma S-adenosylhomocysteine is a more sensitive indicator of the risk for cardiovascular disease than is plasma homocysteine. We measured plasma S-adenosylhomocysteine and total homocysteine in 36 patients with renal insufficiency and in 17 control subjects. The mean (+/- SD) value of S-adenosylhomocysteine for renal patients was 90.4 +/- 49.4 nmol/L, and the corresponding value for control subjects was 25.8 +/- 6.0 nmol/L. The mean value of homocysteine for renal patients was 20.9 +/- 7.2 mumol/L, and the corresponding value for control subjects was 10.9 +/- 2.7 mumol/L. For S-adenosylhomocysteine, the values of four patients overlapped those of control subjects, whereas for homocysteine 10 patient values overlapped control values. S-adenosylhomocysteine is a more sensitive indicator than homocysteine for renal disease (89% v 72%, respectively, P = 0.034). (C) 2004 Elsevier Inc. All rights reserved.