Prevalence of hyperhomocysteinemia in hemodialysis patients in United Arab Emirates, a one center experience, correlation with diabetes mellitus, folate, and dialysis modality

Hyperhomocysteinemia is a non-traditional independent risk factor for cardiovascular disease. It is highly prevalent in Western dialysis patients, while its prevalence in the Middle East is unknown. The aim of this study is to determine the prevalence of hyperhomocysteinemia among our hemodialysis (HD) patients, and to identify correlations between homocysteine and diabetes mellitus (DM), folic acid, and dialysis modality. Homocysteine and folate levels were measured in 83 stable HD patients: 52 males, mean age 56.4±17.6 years, 58% were diabetic, 61% were treated by traditional HD, and 39% treated by online hemodiafiltration (HDF). Of the studied patients, 99% have abnormal homocysteine with a mean level of 27±10.8 mmol/L. The homocysteine level in diabetics and non-diabetics was 28.7±11.3 and 25.5±9.7, respectively (P=0.17); the level in HDF and HD patients was 29.7±10.5 and 25.8±10.5, respectively (P=0.1). In summary, hyperhomocysteinemia is highly prevalent in our HD population.