Determination of Homocysteine and Lipid Profile Level in the Blood of Chronic Kidney Disease Patients with and without Hemodialysis in Comparison to Normal Healthy Individuals

Background: Homocysteine a thiol-containing amino acid is an intermediatory product formed in the metabolic conversion of methionine to cysteine. Patients with chronic kidney disease cause many abnormalities in amino acid and protein metabolism leading to increase in homocysteine concentration. This is due to the deficiency of enzymes or vitamin required as a cofactor for homocysteine metabolism. Objective: The aim of this study is to evaluate the role and measurement of hemocysteine and lipid profile in chronic kidney disease patients with and without hemodialysis in comparison to healthy individuals. Methodology: A case-control analytical study that was conducted at Isra University Hospital, Liaquat University of Medical Science Hospital, Bhitai Hospital Hyderabad. The study subjects were selected through non-probability purposive sampling based on inclusion and exclusion criteria. Total 90 subjects were taken comprised of three groups. Subjects in group-A are normal control healthy individuals. The case subjects were kept in group-B as chronic kidney disease patients with hemodialysis and group-C as chronic kidney disease patients without hemodialysis. Whole blood 5cc was collected for the quantitative determination of homocysteine and lipid profile status of each subject by using assay kits of each variable through Roche 902 automated chemical analyzer. The statistical data was analyzed on SPSS version 21.0. T-test was used to assess the significance with level of ≤0.05. Results: The data obtained by the present study showed that the mean age ± SD in group-A,B and C was found to be as 49.83 ± 5.05, 52.46 ± 5.63 and 50.51 ± 5.39 years respectively with p-value 0.14. In case of homocysteine the mean ± SDin all groups was 7.89 ± 2.78, 28.89 ± 9.27 and 23.44 ± 6.81 with p-value <0.001. The frequency of normal, mild and moderate homocysteine was also noted of each group and the p-value was found to be 0.03. Serum cholesterol showed non-significant difference among the subject of all groups with p-value 0.14. Serum triglycerides and LDL were raised in hemodialytic patients while serum HDL was reduced with p-value 0.0001. Also serum LDL was raised significantly in hemodialytic subjects as compared to non-hemodailytics and control subjects. In addition serum HDL was reduced significantly in the hemodialytics and control subjects with p-value 0.001. The results further showed positive association of hemocysteine with TG and serum LDL while serum HDL on the other hand showed strong negative association however, serum cholesterol showed non-significant weak negative association with homocysteine. Conclusion: It is concluded that homocysteine which is commonly considered as toxic thrombogenic amino acid is found in high concentration in the blood of chronic kidney disease patients particularly in those patients which are on hemodialysis. It is thus suggested that preventive measures should be followed by the clincians treating chronic kidney disease patients who are undergoing on hemodialytic procedures.