Objective: Observe the relationship between homocysteine and other amino acids in patients with end-stage renal disease (ESRD).
Design: A cross-sectional study of amino acids and homocysteine and comparison of the correlations between ESRD and control group.
Setting: Nephrology unit of Soonchunhyang University hospital in Chunan, Korea.
Participants: Forty-five ESRD patients and 30 control volunteers.
Main outcome measures: Plasma amino acids and homocysteine.
Results: Concentrations of asparate, proline and cysteine were higher and serine, tyrosine, valine, isoleuline, leucine, and lysine levels were lower in the ESRD group than in control group. The branched chain amino acids (BCAAs) and essential amino acid were lower in the ESRD group than in the control group, but there was no difference in non-essential amino acid and total amino acid between the two groups. The mean plasma total homocysteine concentrations were 6 +/- 1 mmol/L in the control group and 14 +/- 4 mmol/L in the ESRD group (P < .001). In the ESRD group, homocysteine concentrations showed a direct correlation with the concentration of histidine (R2: .403, P < .001), valine (R2: .324, P < .01), leucine (R2: .400, P < .01), isoleucine (R2: .351, P < .005), cysteine (R2: .287, P < .001), methionine (R2: .256, P < .01), BCAA (R2: .50, P < .01), and essential amino acid (R2: .416, P < .01). In the control group, no correlation between the homocysteine and amino acid concentrations was found.
Conclusions: Contrary to the control group, the homocysteine concentrations showed a direct correlation with the concentration of valine, leucine, isoleucine, methionine, and histidine levels in the ESRD group. Altered essential amino acid metabolism, specifically BCAAs and histidine, influence hyperhomocysteinemia in ESRD. Further study is needed to confirm this theory.