An Insight to Hyperhomocysteinaemia in CKD Patients of a Tertiary Care Hospital, Karachi

To evaluate the frequency and association of hyperhomocysteinaemia (HHcy) in different stages of chronic kidney disease (CKD) patients. Cross-sectional, descriptive study. Place and Duration of the Study: Department of Chemical Pathology, Indus Hospital and Health Network Karachi, Pakistan, from July to December 2022. Blood samples of 100 known CKD patients were collected for this study. The estimated glomerular filtration rate (eGFR) was calculated from the CKD-EPI calculator for CKD staging. Plasma homocysteine (Hcy) and serum creatinine concentrations were analysed on Abbott Alinity I and C analyzers, respectively. The SPSS was used for data compilation and analysis. Descriptive statistics were calculated. The association of HHcy with CKD and other variables was assessed using the Chi-square test as appropriate. A p-value of ≤0.05 was considered as significant. Out of total 100, 52% males and 48% females known CKD patients were included in the study. The mean age of the patients was 50.62 ± 16.29 years. The median eGFR, serum creatinine, and Homocysteine were 18 ml/min/1.73m2, 3.48mg/dl, and 20.07 μmol/l, respectively. The percentage of CKD patients in each stage was 7% in stage 3a, 18% in stage 3b, 30% in stage 4, and 45% in stage 5. HHcy was observed in 79% of the CKD patients and among them 7.6% patients were in stage 3a, 19.0% in stage 3b, 31.6% in stage 4, and 41.8 % in stage 5. Patients with CKD were found to have HHcy indicating a very high level of prevalence in CKD patients, especially in the late stages. Hence, Hcy can be considered as a predictor of advancing disease. Timely interventions are required to prevent future adverse outcomes and improve the quality of life in CKD patients. However, a significant association was not seen between Hcy concentration and eGFR stages in the current study. Hyperhomocysteinaemia, Estimated glomerular filtration rate, CKD-EPI calculator, Mortality, End-stage renal disease, Cardiovascular disease.