Hyperhomocysteinemia and the development of chronic kidney disease in a general population: The Hisayama study

Toshiharu Ninomiya, Yutaka Kiyohara, Michiaki Kubo, Yumihiro Tanizaki, Keiichi Tanaka, Ken Okubo, Hidetoshi Nakamura, Jun Hata, Yoshinori Oishi, Isao Kato, Hideki Hirakata, Mitsuo Iida

Research output: Contribution to journalArticle

58 Citations (Scopus)

Abstract

Background: Hyperhomocysteinemia has been linked with various atherosclerotic diseases, but has not been evaluated sufficiently as a risk factor for the development of chronic kidney disease (CKD) in the general population. Methods: To clarify this issue, we followed up 1,477 community-dwelling individuals without CKD, aged 40 years or older, for 5 years and examined the effects of baseline serum total homocysteine (tHcy) levels on the development of CKD. Results: During follow-up, 88 subjects experienced CKD. Baseline tHcy levels were greater in men than women (1.35 versus 1.04 mg/L [10.0 versus 7.7 μmol/L]; P < 0.01). Age-adjusted 5-year incidences were 2.2% in the low tertile, 5.4% in the middle tertile, and 8.6% in the high tertile of tHcy levels for men and 3.3%, 6.0%, and 6.9% for women, respectively. The difference between the low and high tertiles was statistically significant for both sexes (P < 0.05). In multivariate analysis, these relationships remained substantially unchanged, even after adjustment for other confounding factors, such as systolic blood pressure, antihypertensive medication, hemoglobin A 1c level, total cholesterol level, high-density lipoprotein cholesterol level, habitual smoker status, regular alcohol intake, proteinuria, and baseline kidney function (odds ratio [OR] in the high tertile of tHcy levels, 2.09; 95% confidence interval [CI], 0.66 to 6.61 for men; OR, 2.86; 95% CI, 1.10 to 7.43 for women). Furthermore, baseline tHcy level showed a significantly inverse association with rate of change in kidney function during the 5 years after being adjusted for confounding factors, including baseline kidney function. Conclusion: Our findings suggest that elevated serum tHcy levels are a significant risk factor for the development of CKD in the general population.

Original languageEnglish
Pages (from-to)437-445
Number of pages9
JournalAmerican Journal of Kidney Diseases
Volume44
Issue number3
DOIs
Publication statusPublished - 01-09-2004
Externally publishedYes

Fingerprint

Hyperhomocysteinemia
Homocysteine
Chronic Renal Insufficiency
Population
Kidney
Odds Ratio
Confidence Intervals
Blood Pressure
Independent Living
Hemoglobin A
Serum
Proteinuria
HDL Cholesterol
Antihypertensive Agents
Multivariate Analysis
Cholesterol
Alcohols
Incidence

All Science Journal Classification (ASJC) codes

  • Nephrology

Cite this

Ninomiya, Toshiharu ; Kiyohara, Yutaka ; Kubo, Michiaki ; Tanizaki, Yumihiro ; Tanaka, Keiichi ; Okubo, Ken ; Nakamura, Hidetoshi ; Hata, Jun ; Oishi, Yoshinori ; Kato, Isao ; Hirakata, Hideki ; Iida, Mitsuo. / Hyperhomocysteinemia and the development of chronic kidney disease in a general population : The Hisayama study. In: American Journal of Kidney Diseases. 2004 ; Vol. 44, No. 3. pp. 437-445.
@article{dd08e3a17be84906a0ac10a5e6bba244,
title = "Hyperhomocysteinemia and the development of chronic kidney disease in a general population: The Hisayama study",
abstract = "Background: Hyperhomocysteinemia has been linked with various atherosclerotic diseases, but has not been evaluated sufficiently as a risk factor for the development of chronic kidney disease (CKD) in the general population. Methods: To clarify this issue, we followed up 1,477 community-dwelling individuals without CKD, aged 40 years or older, for 5 years and examined the effects of baseline serum total homocysteine (tHcy) levels on the development of CKD. Results: During follow-up, 88 subjects experienced CKD. Baseline tHcy levels were greater in men than women (1.35 versus 1.04 mg/L [10.0 versus 7.7 μmol/L]; P < 0.01). Age-adjusted 5-year incidences were 2.2{\%} in the low tertile, 5.4{\%} in the middle tertile, and 8.6{\%} in the high tertile of tHcy levels for men and 3.3{\%}, 6.0{\%}, and 6.9{\%} for women, respectively. The difference between the low and high tertiles was statistically significant for both sexes (P < 0.05). In multivariate analysis, these relationships remained substantially unchanged, even after adjustment for other confounding factors, such as systolic blood pressure, antihypertensive medication, hemoglobin A 1c level, total cholesterol level, high-density lipoprotein cholesterol level, habitual smoker status, regular alcohol intake, proteinuria, and baseline kidney function (odds ratio [OR] in the high tertile of tHcy levels, 2.09; 95{\%} confidence interval [CI], 0.66 to 6.61 for men; OR, 2.86; 95{\%} CI, 1.10 to 7.43 for women). Furthermore, baseline tHcy level showed a significantly inverse association with rate of change in kidney function during the 5 years after being adjusted for confounding factors, including baseline kidney function. Conclusion: Our findings suggest that elevated serum tHcy levels are a significant risk factor for the development of CKD in the general population.",
author = "Toshiharu Ninomiya and Yutaka Kiyohara and Michiaki Kubo and Yumihiro Tanizaki and Keiichi Tanaka and Ken Okubo and Hidetoshi Nakamura and Jun Hata and Yoshinori Oishi and Isao Kato and Hideki Hirakata and Mitsuo Iida",
year = "2004",
month = "9",
day = "1",
doi = "10.1053/j.ajkd.2004.05.024",
language = "English",
volume = "44",
pages = "437--445",
journal = "American Journal of Kidney Diseases",
issn = "0272-6386",
publisher = "W.B. Saunders Ltd",
number = "3",

}

Ninomiya, T, Kiyohara, Y, Kubo, M, Tanizaki, Y, Tanaka, K, Okubo, K, Nakamura, H, Hata, J, Oishi, Y, Kato, I, Hirakata, H & Iida, M 2004, 'Hyperhomocysteinemia and the development of chronic kidney disease in a general population: The Hisayama study', American Journal of Kidney Diseases, vol. 44, no. 3, pp. 437-445. https://doi.org/10.1053/j.ajkd.2004.05.024

Hyperhomocysteinemia and the development of chronic kidney disease in a general population : The Hisayama study. / Ninomiya, Toshiharu; Kiyohara, Yutaka; Kubo, Michiaki; Tanizaki, Yumihiro; Tanaka, Keiichi; Okubo, Ken; Nakamura, Hidetoshi; Hata, Jun; Oishi, Yoshinori; Kato, Isao; Hirakata, Hideki; Iida, Mitsuo.

In: American Journal of Kidney Diseases, Vol. 44, No. 3, 01.09.2004, p. 437-445.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Hyperhomocysteinemia and the development of chronic kidney disease in a general population

T2 - The Hisayama study

AU - Ninomiya, Toshiharu

AU - Kiyohara, Yutaka

AU - Kubo, Michiaki

AU - Tanizaki, Yumihiro

AU - Tanaka, Keiichi

AU - Okubo, Ken

AU - Nakamura, Hidetoshi

AU - Hata, Jun

AU - Oishi, Yoshinori

AU - Kato, Isao

AU - Hirakata, Hideki

AU - Iida, Mitsuo

PY - 2004/9/1

Y1 - 2004/9/1

N2 - Background: Hyperhomocysteinemia has been linked with various atherosclerotic diseases, but has not been evaluated sufficiently as a risk factor for the development of chronic kidney disease (CKD) in the general population. Methods: To clarify this issue, we followed up 1,477 community-dwelling individuals without CKD, aged 40 years or older, for 5 years and examined the effects of baseline serum total homocysteine (tHcy) levels on the development of CKD. Results: During follow-up, 88 subjects experienced CKD. Baseline tHcy levels were greater in men than women (1.35 versus 1.04 mg/L [10.0 versus 7.7 μmol/L]; P < 0.01). Age-adjusted 5-year incidences were 2.2% in the low tertile, 5.4% in the middle tertile, and 8.6% in the high tertile of tHcy levels for men and 3.3%, 6.0%, and 6.9% for women, respectively. The difference between the low and high tertiles was statistically significant for both sexes (P < 0.05). In multivariate analysis, these relationships remained substantially unchanged, even after adjustment for other confounding factors, such as systolic blood pressure, antihypertensive medication, hemoglobin A 1c level, total cholesterol level, high-density lipoprotein cholesterol level, habitual smoker status, regular alcohol intake, proteinuria, and baseline kidney function (odds ratio [OR] in the high tertile of tHcy levels, 2.09; 95% confidence interval [CI], 0.66 to 6.61 for men; OR, 2.86; 95% CI, 1.10 to 7.43 for women). Furthermore, baseline tHcy level showed a significantly inverse association with rate of change in kidney function during the 5 years after being adjusted for confounding factors, including baseline kidney function. Conclusion: Our findings suggest that elevated serum tHcy levels are a significant risk factor for the development of CKD in the general population.

AB - Background: Hyperhomocysteinemia has been linked with various atherosclerotic diseases, but has not been evaluated sufficiently as a risk factor for the development of chronic kidney disease (CKD) in the general population. Methods: To clarify this issue, we followed up 1,477 community-dwelling individuals without CKD, aged 40 years or older, for 5 years and examined the effects of baseline serum total homocysteine (tHcy) levels on the development of CKD. Results: During follow-up, 88 subjects experienced CKD. Baseline tHcy levels were greater in men than women (1.35 versus 1.04 mg/L [10.0 versus 7.7 μmol/L]; P < 0.01). Age-adjusted 5-year incidences were 2.2% in the low tertile, 5.4% in the middle tertile, and 8.6% in the high tertile of tHcy levels for men and 3.3%, 6.0%, and 6.9% for women, respectively. The difference between the low and high tertiles was statistically significant for both sexes (P < 0.05). In multivariate analysis, these relationships remained substantially unchanged, even after adjustment for other confounding factors, such as systolic blood pressure, antihypertensive medication, hemoglobin A 1c level, total cholesterol level, high-density lipoprotein cholesterol level, habitual smoker status, regular alcohol intake, proteinuria, and baseline kidney function (odds ratio [OR] in the high tertile of tHcy levels, 2.09; 95% confidence interval [CI], 0.66 to 6.61 for men; OR, 2.86; 95% CI, 1.10 to 7.43 for women). Furthermore, baseline tHcy level showed a significantly inverse association with rate of change in kidney function during the 5 years after being adjusted for confounding factors, including baseline kidney function. Conclusion: Our findings suggest that elevated serum tHcy levels are a significant risk factor for the development of CKD in the general population.

UR - http://www.scopus.com/inward/record.url?scp=4444383502&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=4444383502&partnerID=8YFLogxK

U2 - 10.1053/j.ajkd.2004.05.024

DO - 10.1053/j.ajkd.2004.05.024

M3 - Article

C2 - 15332216

AN - SCOPUS:4444383502

VL - 44

SP - 437

EP - 445

JO - American Journal of Kidney Diseases

JF - American Journal of Kidney Diseases

SN - 0272-6386

IS - 3

ER -